GLP-1 Receptor Agonist Use Across Preconception, Pregnancy, and the Postpartum Periods

Area of Science:

• Reproductive Endocrinology
• Pharmacology
• Maternal-Fetal Medicine

Background:

• Obesity in reproductive-age women poses risks for cardiometabolic disease, infertility, and pregnancy complications.
• Glucagon-like peptide-1 (GLP-1) receptor agonists are effective obesity medications, with increasing use in women of reproductive age.
• While not recommended during pregnancy, their use in preconception, periconception, and postpartum periods is rising.

Purpose of the Study:

• To review the current literature on the risks and benefits of GLP-1 receptor agonist use in reproductive-age women.
• To highlight clinical considerations and evidence gaps regarding GLP-1 receptor agonist use across reproductive stages.
• To emphasize the need for high-quality research on maternal and fetal outcomes.

Main Methods:

• Systematic literature review of studies on GLP-1 receptor agonist use in reproductive-age women.
• Analysis of data focusing on maternal and fetal safety and clinical utility during reproductive windows.
• Identification of evidence gaps and areas for future prospective research.

Main Results:

• Limited data exist on the safety and clinical utility of GLP-1 receptor agonists during preconception, periconception, and postpartum periods.
• The review highlights key clinical considerations for managing these medications across different reproductive stages.
• Human exposure data are prioritized, but significant evidence gaps remain.

Conclusions:

• Further high-quality prospective research is crucial to establish the safety and efficacy of GLP-1 receptor agonists in women of reproductive age.
• Understanding maternal and fetal outcomes is essential given the increasing use of these agents around pregnancy.
• Clinical practice should be guided by available human data while acknowledging the need for more robust evidence.