In keeping with the overall lower birth weight in the metformin-exposed group, macrosomia was lower by 40% compared to the insulin-exposed group (OR 0.59, 95% CI 0.46 to 0.77, I2 = 0%, p < 0.001), although this result may be influenced by publication bias (Fig 3). The gene discussed is INS; the disease is Large for gestational age.