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
Clinical Scorecard: Pregnancy Risks With First Trimester GLP-1 Continuation
At a Glance
Category Detail
Condition Continuation of GLP-1 receptor agonists during the first trimester of pregnancy Key Mechanisms GLP-1 receptor agonists are used for glycemic control in patients with type 2 diabetes. Target Population Pregnant women aged 16 to 55 years who received GLP-1 receptor agonist prescriptions prior to last menstrual period. Care Setting Observational 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
