Pregnancy Risks With First Trimester GLP-1 Continuation - Scorecard - MDSpire

Pregnancy Risks With First Trimester GLP-1 Continuation

Claims-based target trial emulation found no clear association between continued GLP-1 receptor agonist use in early pregnancy and nonlive birth, fetal growth abnormalities, or major congenital malformations.

  • By

  • Andrea Surnit

  • June 17, 2026

  • 3 min

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Clinical Scorecard: Pregnancy Risks With First Trimester GLP-1 Continuation

At a Glance

CategoryDetail
ConditionContinuation of GLP-1 receptor agonists during the first trimester of pregnancy
Key MechanismsGLP-1 receptor agonists are used for glycemic control in patients with type 2 diabetes.
Target PopulationPregnant women aged 16 to 55 years who received GLP-1 receptor agonist prescriptions prior to last menstrual period.
Care SettingObservational study using commercial insurance claims data.

Key Highlights

  • No clear increase in nonlive birth, abnormal fetal growth, or major congenital malformations with GLP-1 continuation.
  • 30% risk of nonlive birth in continuers vs. 27% in noncontinuers; adjusted risk ratio of 1.09.
  • Major congenital malformations found in about 8% of infants exposed to GLP-1 vs. 7% in noncontinuation group.
  • Elective termination more frequent among patients who continued treatment.
  • Similar rates of spontaneous abortion between both groups.

Guideline-Based Recommendations

Diagnosis

  • Monitor pregnancy outcomes in patients continuing GLP-1 receptor agonists.

Management

  • Consider individual patient circumstances regarding GLP-1 continuation during pregnancy.

Monitoring & Follow-up

  • Evaluate neonatal outcomes and potential risks associated with GLP-1 receptor agonist exposure.

Risks

  • Potential residual confounding related to glycemic control not fully measurable in claims data.

Patient & Prescribing Data

Pregnant women aged 16 to 55 years with prior GLP-1 prescriptions.

Most patients classified as continuers received only one additional prescription after conception.

Clinical Best Practices

  • Assess pregnancy intention and concerns about drug exposure in patients considering GLP-1 continuation.
  • Be aware of limitations in observational study designs when interpreting results.

Related Resources & Content

Original Source(s)

Pregnancy Risks With First Trimester GLP-1 Continuation

  • by Andrea Surnit

  • June 17, 2026

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