GLP-1 Agonist Use Around Pregnancy: Safety Gaps and Clinical Needs

Obesity in reproductive-age women is a growing concern, associated with increased risks of cardiometabolic disease, infertility, and various pregnancy-related complications affecting both the mother and fetus. The recent introduction of highly effective glucagon-like peptide-1 (GLP-1) receptor agonists has led to their increased utilization for obesity management in this demographic. However, while these agents are generally not recommended during pregnancy, there is a significant lack of comprehensive data on their safety and clinical utility during the preconception, periconception, and postpartum periods.

The review revealed that despite the increasing use of GLP-1 receptor agonists in reproductive-aged women, robust safety and efficacy data for preconception, periconception, and postpartum periods remain severely limited. While these medications are generally advised against during pregnancy, their rising use in adjacent reproductive windows underscores an urgent need for more information. The most critical finding is the significant lack of high-quality research and prospective studies specifically addressing the safety and efficacy of GLP-1 receptor agonists for both maternal and fetal outcomes in preconception, periconception, and postpartum women. The authors emphasized that current literature provides insufficient guidance for clinical practice, highlighting the need for dedicated research to inform safe and effective treatment strategies.