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

Obesity in reproductive-age women is associated with increased risk of cardiometabolic disease, infertility, and pregnancy-related complications affecting both the mother and fetus. Recently, the introduction of highly effective glucagon-like peptide-1 (GLP-1) receptor agonists has led to increased utilization of obesity medications in this population. While these agents are not recommended during pregnancy, their use in the preconception, periconception, and postpartum periods is increasing. Yet, data on their safety and clinical utility during these reproductive windows remain limited. This review summarizes the current literature on the risks and benefits of GLP-1 receptor agonist use for both the mother and fetus, highlighting the need for ongoing high-quality research in this population. This review highlights key clinical considerations across reproductive stages, emphasizes the primacy of human exposure data where available, and identifies critical evidence gaps requiring future prospective study.