Gestational diabetes & diabetes in pregnancy
Continuing Glucagon-Like Peptide-1 Receptor Agonists Into the First Trimester of Pregnancy and Pregnancy Outcomes : A Target Trial Emulation Study Using Claims Information
Main finding · Nonlive birthResult — go to the resultAdjusted risk ratio 1.09 95% CI 0.98–1.23Authors' conclusion
Risks for nonlive birth, SGA, LGA, and MCM were not definitively higher with continuation of GLP-1RAs into early pregnancy. However, estimates for MCM and SGA were imprecise and were compatible with both no increased risk and clinically relevant differences in risk.
Study context
- Population
- Pregnant women aged 16 to 55 years with a GLP-1RA dispensation in the 90 days before the last menstrual period (LMP); Merative MarketScan U.S. insurance claims data (2011 to 2024)
- Participants
- 3,572 pregnancies
- Exposure
- Continuation of GLP-1RA dispensing into the first trimester vs noncontinuation
- Outcome
- Risk for nonlive birth
Methodological detailsweighted analysis, insurance claims data, Limitation: potential residual confounding by prior glycemic control
- Weighted analysis
- Insurance claims data
- Limitation: potential residual confounding by prior glycemic control
Main finding
Nonlive birth
Adjusted risk ratio
1.09
95% CI 0.98–1.23
By group
Continuationvs Noncontinuation
adjusted risk ratio 1.09 (95% CI 0.98–1.23)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Weighted prevalence ratio (CI) | |
|---|---|---|
| SGA (live-birth pregnancies linked to infants) | 1.29 (0.82–2.06) | |
| LGA (live-birth pregnancies linked to infants) | 1.08 (0.84–1.40) | |
| MCM (live-birth pregnancies linked to infants) | 1.21 (0.83–1.82) | |
| 0.512Weighted prevalence ratio (log scale) |
- Small for gestational age (SGA) (live-birth pregnancies linked to infants): 1499 linked to an infant (829 continuers)
Original publication
Continuing Glucagon-Like Peptide-1 Receptor Agonists Into the First Trimester of Pregnancy and Pregnancy Outcomes : A Target Trial Emulation Study Using Claims Information. Ann Intern Med. Published 9 June 2026. doi:10.
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