GLP-1 receptor agonists show promising potential for maternal cardiometabolic health, but critical data gaps remain

Cardiovascular disease (CVD) is a leading cause of maternal mortality, with adverse pregnancy outcomes (APOs) like preeclampsia and gestational diabetes significantly increasing long-term cardiometabolic risk. Current prevention strategies for these high-risk women during preconception and postpartum are limited. Glucagon-like peptide-1 receptor agonists (GLP-1 agonists) and combined therapies have demonstrated substantial benefits in weight reduction, glycemic control, and cardiovascular risk reduction in nonpregnant populations, but their specific impact on maternal cardiometabolic health during peripartum phases remains undefined.

This comprehensive review synthesized existing literature on GLP-1 receptor agonists and combined therapies, evaluating their mechanisms, safety, and efficacy relevant to reproductive-age women. The authors focused on their potential application during the preconception and postpartum periods, identifying current clinical uncertainties and data gaps. They critically assessed available evidence concerning cardiometabolic health outcomes in women with increased cardiovascular disease risk, aiming to highlight opportunities for future research and guide evidence-based integration into preventative care.

The review confirmed that GLP-1 agonists are not currently approved for use during pregnancy or lactation, yet emerging evidence suggests a potential role in preconception weight optimization and postpartum metabolic recovery. The authors highlighted the established mechanisms by which GLP-1 agonists improve weight reduction, glycemic control, and lipid profiles in nonpregnant populations. However, a critical finding was the significant lack of data specific to reproductive-age populations, particularly concerning safety and efficacy during peripartum phases. This gap extends to optimal timing of use and practical implementation strategies. The review underscored that while GLP-1 agonists represent a promising preventive strategy for cardiometabolic risk reduction in high-risk women, current evidence is insufficient to guide clinical practice. They emphasized the need for focused research to address these uncertainties.

The most significant finding was the identification of critical gaps in safety, efficacy, optimal timing, and implementation data for GLP-1 agonists in reproductive-aged women, despite their clear potential.