HealthDay News — A recent study published in the Journal of the American Medical Association has highlighted potential risks associated with the discontinuation of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) before or during early pregnancy. The research indicates that stopping these medications can lead to increased gestational weight gain and a higher incidence of preterm delivery, gestational diabetes, and hypertensive disorders of pregnancy.
The study, led by Dr. Jacqueline Maya from Massachusetts General Hospital-Mass General Brigham in Boston, involved a retrospective cohort analysis of 149,790 singleton pregnancies delivered between June 1, 2016, and March 31, 2025. The primary focus was on comparing pregnancy outcomes and weight gain in pregnancies exposed to GLP-1 RAs before or during early pregnancy against those that were not.
Key Findings and Implications
The analysis included 1,792 matched pregnancies, with 448 pregnancies exposed to GLP-1 RAs and 1,344 unexposed. Notably, 84% of the exposed group had obesity, and 23% had preexisting diabetes. The findings revealed that pregnancies exposed to GLP-1 RAs experienced greater gestational weight gain, averaging 13.7 kg compared to 10.5 kg in unexposed pregnancies.
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%), and a higher risk for preterm delivery, gestational diabetes, and hypertensive disorders of pregnancy (risk ratios, 1.34, 1.30, and 1.29, respectively).
Interestingly, the study found no significant differences in birth length, risk for large- or small-for-gestational-age birth weight, or cesarean delivery between the two groups.
Expert Opinions and Future Directions
Dr. Camille E. Powe, a senior author of the study, emphasized the need for further research to balance the prepregnancy benefits of GLP-1 RAs with the risks associated with their discontinuation during pregnancy. “We need to do more research to find ways to help manage weight gain and reduce risks during pregnancy when stopping GLP-1 medications,” Dr. Powe stated.
The study’s findings underscore the complexity of managing chronic conditions such as obesity and diabetes during pregnancy, particularly when medications like GLP-1 RAs are involved. Several authors of the study disclosed ties to the medical technology and publishing industries, highlighting the ongoing collaboration between clinical research and industry stakeholders.
Context and Historical Parallels
The use of GLP-1 RAs, primarily for managing type 2 diabetes and obesity, has been on the rise due to their efficacy in controlling blood sugar levels and promoting weight loss. However, their safety and efficacy during pregnancy remain areas of active investigation. Historically, managing chronic conditions during pregnancy has posed significant challenges for healthcare providers, necessitating a careful balance between maternal and fetal health.
Previous studies have shown that the discontinuation of certain medications during pregnancy can lead to adverse outcomes, emphasizing the importance of comprehensive prenatal care and individualized treatment plans. The current study adds to the growing body of evidence that suggests the need for tailored approaches to medication management in pregnant individuals with chronic health conditions.
Looking Ahead
As the medical community continues to explore the implications of GLP-1 RA discontinuation during pregnancy, healthcare providers are urged to consider these findings when advising patients. The study highlights the critical need for ongoing research to develop strategies that mitigate the risks associated with stopping GLP-1 medications while ensuring optimal pregnancy outcomes.
In conclusion, the study’s findings serve as a reminder of the complexities involved in managing chronic conditions during pregnancy and the need for a nuanced approach to medication management. As further research unfolds, it will be crucial for healthcare providers to stay informed and adapt their practices to ensure the best possible outcomes for both mothers and their babies.
