Exposure to High-Dose Liraglutide in a Pregnant Woman With Obesity

Animal studies indicate that liraglutide is not recommended for managing gestational diabetes mellitus and obesity during pregnancy due to potential developmental toxicity. We report a case of liraglutide exposure during the first trimester in a woman with obesity taking the maximum dose (3 mg subcutaneously daily), along with a neurodevelopmental assessment of the child conducted 14 months postpartum. Additionally, this report includes a literature review on the teratogenic effects of anti-obesity medications.

A 29-year-old woman, gravida 9 para 6, with obesity and no history of chronic diseases was admitted at 7 weeks of gestation after taking liraglutide 3 mg/d subcutaneously for weight loss for 8 months. Liraglutide was immediately discontinued, and routine antenatal management was initiated. The patient underwent cesarean delivery at 37 weeks of gestation; the neonate had low birth weight but was otherwise healthy. Follow-up during 14 months postpartum indicated appropriate childhood weight gain and normal neurodevelopmental assessment for age.

This case report demonstrates a normal pregnancy outcome after exposure to a high dose of liraglutide during the first 7 weeks of pregnancy, apart from a low birth weight. These findings enhance the limited understanding of liraglutide exposure during pregnancy. More studies are required to establish a causal relationship between neonatal weight and liraglutide exposure. Longitudinal follow-up of children beyond 14 months is essential to evaluate growth and neurodevelopmental outcomes and assess any long-term teratogenic effects from anti-obesity drugs.