No detectable increase in pregnancy risks after GLP-1 exposure around conception, largest review to date finds

by City St George's, University of London

edited by Sadie Harley, reviewed by Robert Egan

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Exposure to GLP-1 weight-loss and diabetes drugs around conception is not linked to a clearly detectable increase in adverse outcomes for mothers or babies, according to the largest study of its kind, involving more than 2.1 million pregnancies and led by researchers at City St George's.

GLP-1 receptor agonists are a class of medicines used to treat obesity and type 2 diabetes. They include semaglutide, sold under brand names such as Ozempic and Wegovy, and tirzepatide, marketed as Mounjaro. Their popularity has grown rapidly in recent years, with increasing numbers of women of reproductive age using these medicines.

Current clinical guidance recommends that women stop taking GLP-1 receptor agonists before a planned pregnancy because there is limited evidence about their effects during pregnancy. However, because many pregnancies are unplanned, women are often exposed to these medications before they know they are pregnant.

But this study offers reassuring evidence for women who inadvertently become pregnant while taking GLP-1s.

Evidence from more than two million pregnancies

The study, published in Med, is the largest systematic review and meta-analysis on this topic to date.

Led by professor Asma Khalil, researchers examined data from 10 studies that had investigated pregnancy outcomes among women who had been exposed to GLP-1 receptor agonists during the periconceptional period. This included before conception and in the very early stages of pregnancy before pregnancy was recognized.

The analysis included 2,118,215 pregnancies, including 8,325 pregnancies in which the mother had been exposed to a GLP-1 receptor agonist around the time of conception and within six months before a positive pregnancy test.

Following inadvertent GLP-1 exposure around conception, researchers found no clearly detectable increase in the risk of miscarriage, stillbirth, congenital anomalies, preterm birth, gestational diabetes, high blood pressure disorders of pregnancy, excessive maternal weight gain or babies being unusually small or large at birth compared with pregnancies that had no exposure to GLP-1 receptor agonists.

Khalil, Professor of Obstetrics and Maternal Fetal Medicine in the School of Health & Medical Sciences, said, "Health care professionals are seeing more women who become pregnant while taking these GLP-1 medications such as Ozempic and Mounjaro.

"For many women, discovering they were taking one of these drugs before they realized they were pregnant can be a source of enormous anxiety. One of the questions we are most commonly asked is whether this exposure could have harmed their baby."

Pregnancy safety remains unproven

The authors caution that these findings should not be interpreted as proof that GLP-1 receptor agonists are safe to use during pregnancy. The available evidence comes from observational studies, which can identify patterns and associations but cannot establish cause and effect.

Further research is needed before definitive conclusions can be drawn about the safety of these medications during pregnancy.

Khalil added, "These findings are reassuring and will help clinicians provide evidence-based advice to women who find themselves in this situation. However, it is important to stress that our findings do not establish that these medications are safe during pregnancy. The evidence remains observational, and current recommendations to discontinue GLP-1 receptor agonists before a planned pregnancy should continue to be followed.

"The message for patients is that if you discover you were taking one of these medicines before you knew you were pregnant, you should not panic. Speak to your health care team, who can provide personalized advice and support."

The authors say the findings have important public health implications and hope the study will help address uncertainty among both patients and health care professionals, while highlighting the need for further research into medication use during pregnancy.

Publication details

Francesco D'Antonio et al, GLP-1 receptor agonist exposure in the periconceptional period and adverse obstetric outcomes: A systematic review and meta-analysis, Med (2026). DOI: 10.1016/j.medj.2026.101267

Journal information: Med

Key medical concepts

Glucagon-Like Peptide-1 Receptor AgonistsCongenital AbnormalitiesAbortion, SpontaneousStillbirthPremature Birth

Clinical categories

Obstetrics & gynecologyPregnancyEndocrinologyClinical pharmacologyWeight management Provided by City St George's, University of London Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Robert Egan

Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →

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