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Incretin-Based Medications in Women and Reproduction: A Systematic Scoping Review and Consensus Guidelines for
Kate Maslin1,2, Jill Shawe1,2,3, Sinead Blowers1,3
1School of Nursing and Midwifery, University of Plymouth, Plymouth, Devon, UK.
Summary
Incretin-based medications are generally contraindicated in pregnancy and breastfeeding due to unknown risks. This review found no studies reporting increased congenital anomalies, informing clinical practice guidelines for women
Area of Science:
- Reproductive Endocrinology
- Pharmacology
- Maternal-Fetal Medicine
Background:
- Incretin-based medications are currently contraindicated during pregnancy and breastfeeding due to potential teratogenic risks.
- Existing evidence on the safety and efficacy of these medications in women of reproductive age is limited.
- There is a need to evaluate the risks and benefits across the reproductive lifecycle: contraception, preconception, pregnancy, and postpartum.
Purpose of the Study:
- To systematically scope the existing evidence on incretin-based medications concerning preconception, pregnancy, and postnatal health.
- To identify potential risks and benefits associated with incretin-based medication use in these reproductive stages.
- To develop expert-informed guidelines for clinical practice regarding incretin-based medications in women's reproductive health.
Main Methods:
- An international multidisciplinary expert group was convened to refine research questions using a lifecourse approach.
- A systematic literature search was conducted across multiple databases and grey literature sources.
- Data from human studies were prioritized, with independent screening, data extraction, and narrative synthesis by two authors.
Main Results:
- Thirty-four articles were included, comprising randomized trials, observational studies, case reports, and animal studies.
- Evidence addressed 56.3% of research questions, primarily focusing on preconception and pregnancy usage.
- No studies reported an increase in congenital anomalies; limited data existed on lactation and long-term offspring outcomes.
Conclusions:
- The review identified evidence gaps and provided recommendations for clinical practice and future research.
- Recommendations cover contraception, preconception care, nutritional support, pregnancy monitoring, lactation, and long-term outcomes.
- Further research is needed to fully elucidate the safety profile of incretin-based medications throughout the reproductive lifespan.
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