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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 3

(710) Association of Glucagon Like Peptide-1 Agonist (GLP1) use With Pregnancy Outcomes

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective:

Treatment of obesity with GLP1 improves metabolic health and national use is rising since approval in 2017. As unintended pregnancy rates are >40%, GLP1 pregnancy exposures may be increasing. Data are limited on pregnancy outcomes after exposure. We quantified the risks of adverse pregnancy outcomes after GLP1 exposure and how duration of use modifies these associations.


Study Design:

Retrospective cohort study of singleton deliveries at a single US center from 2017-2024.  Pregnancies after GLP1 use (Semaglutide, Tirzepatide) were matched (1:many ratio) on BMI and demographics to unexposed pregnancies using propensity scores. The primary outcome was a composite of hypertensive disorders of pregnancy (HDP), fetal macrosomia or growth restriction. Secondary outcomes included fetal anomalies, NICU admission, mode of delivery and gestational weight gain (GWG). Regression models estimated the association between GLP1 use and study outcomes. Stratification by duration of use prior to pregnancy ( >1yr, ≤1yr) was performed.


Results:

Fifty-eight exposed patients were matched to 1578 unexposed patients. Among 1636 patients, 86% were obese, 31% had pregestational diabetes and mean weight at first prenatal visit was 110±27kg. Forty-five patients used GLP1 for ≤1 year. Mean weight change with GLP1 use until pregnancy was -0.11±6.44kg. There were no significant differences between groups after propensity score matching. The primary outcome occurred in 37(64.0%) exposed patients and 864 (54.8%) unexposed patients (OR 1.46, 95% CI 0.84-2.51). Exposed patients had a higher odds of GWG (difference 2.36kg, 95% CI 1.43-3.29) and NICU admission (OR 1.85, 95% CI 1.10-3.13). Other secondary outcomes were similar between both groups.  In stratified analysis, NICU admission and GWG risks were significantly higher only with preconception use ≤1yr.


Conclusion:

GLP1 use was not associated with HDP/fetal growth disorders. However, preconception use ≤1yr may have higher NICU admission/GWG risks. Future studies of weight trajectories by use duration and timing of discontinuation are needed.