A systematic review published in Scientific Reports found no statistically significant increase in major congenital malformations, stillbirths, or preterm births following maternal exposure to GLP-1 receptor agonists. While the data offers “cautious reassurance” for inadvertent exposure, researchers state the evidence certainty remains low, meaning these medications are not yet considered safe for routine use during pregnancy.
GLP-1 Receptor Agonists and Pregnancy Risk Data
Researchers analyzed seven cohort studies involving more than 40,000 pregnancies to determine if GLP-1 drugs—commonly used for type 2 diabetes and obesity—impact fetal development. The meta-analysis, which followed PRISMA 2020 guidelines, found an odds ratio (OR) of 1.11 for overall congenital disabilities, which is not statistically significant.
For pregnancies exposed specifically during the first trimester, the risk remained statistically insignificant with an OR of 1.39 across 825 exposed pregnancies. The study focused heavily on semaglutide and liraglutide, though exenatide, dulaglutide, and tirzepatide were also present in the data sets.
Analyzing the Urinary Malformation Signal
The study identified a statistically significant association with urinary congenital malformations (OR 1.24). However, the authors caution that this finding is based on unadjusted estimates and was largely driven by a single large cohort.
According to the Scientific Reports analysis, this specific link may reflect confounding factors—such as pre-existing maternal diabetes or obesity—rather than the medication itself. The researchers noted that neither study provided specific urinary malformation subtypes, which limits the ability to draw a causal conclusion.
Comparing Pregnancy Outcomes and Evidence Certainty
The research team utilized the GRADE system to assess the certainty of their findings, labeling the overall evidence as “low” or “very low.” This rating stems from imprecise estimates and variations in how different studies defined exposure.
| Outcome Measured | Statistical Significance | Finding |
|---|---|---|
| Major Malformations | No | OR 1.11 (Overall) |
| Cardiac Malformations | No | OR 0.92 |
| Urinary Malformations | Yes | OR 1.24 (Unadjusted) |
| Preterm Birth | No | OR 1.17 |
Stillbirth and Spontaneous Abortion Findings
The data on stillbirths showed an elevated point estimate (OR 2.17), but the result did not reach statistical significance due to a wide confidence interval. This means the researchers cannot exclude the possibility of a clinically significant increase in risk.
Conversely, the analysis of spontaneous abortions (OR 0.95) and small-for-gestational-age births (OR 0.84) showed no evidence of an association with GLP-1 receptor agonist exposure.
Future Research Requirements
The authors conclude that while the results are reassuring for those who accidentally took the medication during early pregnancy, the drugs are not cleared for routine prenatal use. They argue that current data is hindered by a lack of standardized exposure definitions and inconsistent prescription records.
To move beyond “low-certainty” data, the researchers call for larger population studies that feature detailed outcome classification and comprehensive adjustments for confounding variables like maternal health history.
Frequently Asked Questions
Are GLP-1 drugs safe to take during pregnancy?
Current evidence from the Scientific Reports meta-analysis does not establish that these drugs are safe for routine use during pregnancy, though it found no significant link to major congenital malformations.
What happens if I accidentally took a GLP-1 drug while pregnant?
The study provides “cautious reassurance” that inadvertent exposure, particularly in the first trimester, is not associated with a statistically significant increase in major birth defects.
Which medications were included in this study?
The analysis included semaglutide, liraglutide, exenatide, dulaglutide, and tirzepatide.
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