Teratogenic risks of treated and untreated maternal obesity

Area of Science:

• Reproductive Medicine
• Endocrinology
• Public Health

Background:

• Untreated obesity in pregnancy leads to adverse fetal and neonatal outcomes, impacting offspring's long-term health and perpetuating obesity across generations.
• Current preconception weight loss strategies are largely ineffective in mitigating these risks.
• Anti-obesity medications (AOMs) are understudied for pregnancy due to teratogenicity concerns, and current guidelines often overlook obesity as a chronic disease.

Purpose of the Study:

• To review the risks of maternal obesity for offspring health.
• To discuss current and emerging treatment strategies for obesity in pregnancy.
• To provide guidance for patient-centered counseling regarding AOMs, particularly GLP-1 RAs, before and during pregnancy.

Main Methods:

• Literature review of risks associated with maternal obesity.
• Analysis of current preconception and prenatal care strategies.
• Evaluation of evidence regarding AOMs, focusing on GLP-1 RAs, in the context of pregnancy.

Main Results:

• Maternal obesity poses significant long-term health risks to offspring, including obesity and cardiometabolic disease.
• Existing preconception interventions have limited effectiveness.
• Emerging evidence suggests potential safety and efficacy of GLP-1 RAs in early pregnancy, warranting further research.

Conclusions:

• Obesity in pregnancy requires a chronic disease management approach.
• GLP-1 RAs represent a promising, yet understudied, AOM class for managing obesity preconceptionally and potentially during early pregnancy.
• Further research is crucial to establish safety and efficacy, enabling informed, patient-centered counseling for providers.