GLP-1 RA use with subsequent prepregnancy or early pregnancy discontinuation linked to higher risk for preterm delivery, gestational diabetes
TUESDAY, Nov. 25, 2025 (HealthDay News) — Glucagon-like peptide-1 receptor agonist (GLP-1 RA) use with subsequent prepregnancy or early pregnancy discontinuation is associated with more gestational weight gain and a higher risk for preterm delivery, gestational diabetes, and hypertensive disorders of pregnancy, according to a study published online Nov. 24 in the Journal of the American Medical Association.
Jacqueline Maya, M.D., from Massachusetts General Hospital-Mass General Brigham in Boston, and colleagues conducted a retrospective cohort study of 149,790 singleton pregnancies delivered between June 1, 2016, and March 31, 2025, to compare weight gain and pregnancy outcomes with and without exposure to GLP-1 RAs before or during early pregnancy. The primary analysis included 1,792 matched pregnancies (448 exposed [84 percent with obesity and 23 percent with preexisting diabetes] and 1,344 unexposed).
The researchers found that the GLP-1 RA-exposed pregnancies had greater gestational weight gain than propensity score-matched unexposed pregnancies (mean, 13.7 versus 10.5 kg). Compared with unexposed pregnancies, the GLP-1 RA-exposed group had a higher risk for excess gestational weight gain (risk ratio, 1.32), greater mean birth weight percentile (58.4 versus 54.8 percent), and a higher risk for preterm delivery, gestational diabetes, and hypertensive disorders of pregnancy (risk ratios, 1.34, 1.30, and 1.29, respectively). No difference was seen in birth length, risk for large- or small-for-gestational-age birth weight, or cesarean delivery.
“Additional studies are needed on the balance of prepregnancy benefits of GLP-1s with the risks associated with interrupting them for pregnancy,” senior author Camille E. Powe, M.D., also from Mass General Brigham, said in a statement. “We need to do more research to find ways to help manage weight gain and reduce risks during pregnancy when stopping GLP-1 medications.”
Several authors disclosed ties to the medical technology and publishing industries.
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