A BJOG narrative review gathered the evidence on women exposed to GLP-1 receptor agonists such as semaglutide or liraglutide shortly before or early in pregnancy. Use is rising among women of reproductive age, and the authors note that exposure is probably under-recorded because routine enquiry is not universal.
Available human observational data have not shown a clear increase in congenital anomalies, hypertensive disorders, preterm birth or other adverse outcomes after periconception exposure. But the studies are small, observational and prone to confounding, and they cannot exclude a clinically important risk.
The practical change is in what you ask and how you counsel. Asking about weight-loss and diabetes injections at booking finds exposures that would otherwise be missed. A woman who conceived while taking one should hear that current evidence is reassuring but incomplete — neither proven safe nor shown to be harmful — and her care should follow from that.
- Ask directly about weight-loss or diabetes injections at booking, including those bought privately
- Record the drug, dose and last dose date when exposure is found
- Counsel that no clear harm signal has been seen, but the data are too limited to call it safe
- Discuss reliable contraception with women of reproductive age starting a GLP-1 receptor agonist
- Plan routine anomaly screening as usual; the review does not support extra testing on exposure alone
Why it matters
These drugs are now common in women of reproductive age, and exposure goes unrecorded unless someone asks.
Don't overread it
This is a narrative review of observational data, not a finding that the drugs are safe in pregnancy.
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