GLP1 Periconception Exposure and OB Outcomes

From Dr. Chapa’s OBGYN Clinical Pearls Dr. Chapa’s Clinical Pearls

There is no denying it, you know of one or MORE individuals or patients currently on a GLP1 agent. Although not FDA approved for PCOS as a stand-alone diagnosis, there is growing evidence supporting their offlabel use in PCOS, and international guidelines now include them as a conditional recommendation. In women, the weight loss associated with these medications may trigger the return of spontaneous ovulation, making mistimed pregnancy a possibility. A key study by Sanz and Blázquez (back in 2011) demonstrated that both GLP-1 and the GLP-1 receptor are present in mouse embryos as early as embryonic day 6 (E6) and continue through the first trimester, as well as in pluripotent mouse embryonic stem cells. In these undifferentiated cells, GLP-1 modified the expression of endodermal, ectodermal, and mesodermal gene markers, as well as critical developmental signaling molecules. So, there is a concern about embryogenesis if inadvertent exposure to these meds occurs in early pregnancy. In this episode, we will summarize 2 recent and separate systematic reviews (March 2026; April 2026) on fetal/OB outcomes after periconceptional exposure. This builds on the Parker data set from 2025. One of these reviews, from April 2026, is also a meta-analysis. Listen in for details.

1. Ozbek L, Shah E, Al-Shiab R, Inal A, Guldan M, Afsar B, Covic A, Kanbay M. 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. 2026 Mar 26. https://pubmed.ncbi.nlm.nih.gov/41885132/

2. Hakim J, Rajesh D, Tello J. Neonatal and Obstetric Outcomes Following Periconceptional Exposure to Glucagon-Like Peptide-1 Receptor Agonists: A Systematic Review and Meta-analysis. AJOG; April 28, 2026; https://www.ajog.org/article/S0002-9378(26)00222-X/fulltext

3. Parker CH, et al. Glucagon-Like Peptide 1 (GLP-1) Receptor Agonists' Use During Pregnancy: Safety Data From Regulatory Clinical Trials. Diabetes, Obesity & Metabolism. 2025.