Glucagon-like Peptide-1 Receptor Agonist Use in Pregnancy: a Review

( Am J Obstet Gynecol . 2025;232(1):17-25. doi: 10.1016/j.ajog.2024.08.024) Glucagon-like peptide-1 receptor agonists (GLP-1RAs), including semaglutide and liraglutide, have gained popularity for treating type 2 diabetes mellitus (T2DM) and obesity due to their effectiveness in lowering blood sugar levels, improving cardiovascular health, and promoting weight loss. The mechanisms of GLP-1RAs include stimulating insulin release, inhibiting glucagon, delaying gastric emptying, and promoting satiety. These effects lead to improved blood glucose control and weight loss. GLP-1RAs are used in patients with T2DM or obesity, and those with cardiovascular disease, often in combination with insulin or metformin. As obesity rates climb and more women use GLP-1RAs, there has been an uptick in unintended pregnancies, especially among women who previously struggled with infertility due to conditions like polycystic ovarian syndrome (PCOS). These medications can restore ovulation and fertility, which increases the likelihood of conception. However, limited data exist about the safety of GLP-1RAs during early pregnancy.