Safety of GLP ‐1 and Dual GLP ‐1/ GIP Receptor Agonists in Preconception, Pregnancy, and Lactation: A Systematic Review of Maternal, Fetal, and Neonatal Outcomes
Authors' conclusion
Current evidence suggests that preconceptional or early-pregnancy exposure to GLP-1-based therapies is not consistently associated with increased maternal, fetal, or neonatal risk, although data on continued use throughout gestation remain limited.
Study context
- Population
- Women with preconception, in-pregnancy or postpartum exposure to GLP-1 or dual GLP-1/GIP receptor agonists; databases searched from inception to 23 September 202536 studies
- Comparison
- GLP-1-based therapy exposure vs insulin-treated or disease-matched controls
- Outcome
- Maternal, fetal, neonatal and lactation outcomes
Methodological detailsnarrative synthesis, PRISMA 2020
- Narrative synthesis
- PRISMA 2020
Pooled result
As reported in the abstract
Fetal and neonatal outcomes
- Periconceptional or early-pregnancy exposure not consistently associated with increased risk of major congenital malformations (adjusted analyses), fetal growth restriction, stillbirth or neonatal mortality vs insulin-treated or disease-matched controls
- Large observational cohorts
Further pooled results
Maternal outcomes (GDM, hypertensive disorders, preterm birth, gestational weight gain)
- Heterogeneous without a reproducible safety signal
Polycystic ovary syndrome (PCOS)
- In women with PCOS, GLP-1 RAs seem promising in various aspects
Lactation
- Lactation data sparse; one pharmacokinetic study reported no detectable semaglutide transfer into human milk
Original publication
Safety of GLP ‐1 and Dual GLP ‐1/ GIP Receptor Agonists in Preconception, Pregnancy, and Lactation: A Systematic Review of Maternal, Fetal, and Neonatal Outcomes. Diabetes Obes Metab. Published 26 March 2026. doi:10.
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