Although preterm birth rate was significantly higher in metformin compared to insulin, metformin showed better maternal outcomes in terms of weight gain and pregnancy induced hypertension than insulin and better outcomes compared to glyburide in maternal weight gain and lower rates of macrosomia [39]; and it is notable that in women with PCOS, metformin treatment decreased the rate of preterm birth [40]. Here, INS is linked to Large for gestational age.