GLP-1 receptor agonists have become some of the most widely discussed medications in recent years. Drugs such as semaglutide, liraglutide, dulaglutide, exenatide, and tirzepatide are commonly prescribed for weight management and type 2 diabetes. As their popularity continues to rise among women of reproductive age, an important question has emerged: What happens if pregnancy occurs while taking a GLP-1 medication?
A newly published U.S. study provides valuable insight into this issue. Researchers examined pregnancy outcomes among women who were using GLP-1 receptor agonists before conception and compared those who continued treatment into the first trimester with those who stopped after becoming pregnant.
The findings offer a degree of reassurance, although experts caution that more research is still needed.
The use of GLP-1 receptor agonists has expanded dramatically in recent years. These medications are highly effective for improving blood sugar control and supporting weight loss. Because many women taking these drugs are in their childbearing years, accidental exposure during early pregnancy has become increasingly common.
Current prescribing recommendations generally advise stopping GLP-1 medications before pregnancy. However, many pregnancies are unplanned, meaning some women may continue taking these medications during the critical early weeks before realizing they are pregnant.
Animal studies have previously raised concerns about possible risks, including pregnancy loss, lower fetal weight, and congenital abnormalities. Human data, however, have remained limited.
Researchers analyzed insurance claims data from the United States covering the years 2011 through 2024. The study included 3,572 pregnancies among women who had received a GLP-1 prescription within 90 days before their last menstrual period.
The investigators compared two groups:
The study focused on several important outcomes:
Researchers used advanced statistical methods to account for differences between the groups and estimate potential risks as accurately as possible.
One of the most important findings was that continuing GLP-1 therapy into early pregnancy did not appear to significantly increase the overall risk of nonlive birth.
The estimated risk of nonlive birth was:
Although the continuation group showed a slightly higher percentage, researchers concluded that the difference was not definitive and could represent little to no actual increase in risk.
The study also examined major congenital malformations, which are serious structural abnormalities present at birth.
Researchers found no strong evidence that first-trimester exposure substantially increased the risk of major congenital malformations compared with discontinuation.
This result aligns with previous observational studies that have generally failed to identify a major increase in birth defect risk associated with early GLP-1 exposure.
However, investigators noted that the confidence intervals were wide, meaning a small increase or decrease in risk cannot be completely ruled out.
The researchers also evaluated infant growth outcomes.
Compared with women who stopped treatment, women who continued GLP-1 medications during early pregnancy did not show a clearly elevated risk of:
The findings suggest that early exposure may not have a major impact on fetal growth, although further investigation is needed.
For many women, discovering a pregnancy while taking a GLP-1 medication can be extremely stressful. Concerns about miscarriage, birth defects, and long-term developmental issues often arise immediately.
This study provides some reassurance because it did not identify a substantial increase in several major adverse pregnancy outcomes associated with early exposure.
Importantly, most women who continued treatment only received limited exposure during the first trimester. Many likely stopped treatment shortly after learning they were pregnant.
The results therefore help address one of the most common real-world scenarios: accidental exposure before pregnancy recognition.
While the findings are encouraging, they should not be interpreted as proof that GLP-1 medications are completely safe during pregnancy.
Several limitations remain:
The study used insurance claims rather than randomized clinical trials. Researchers could adjust for many factors, but some differences between groups may still have influenced results.
The investigators did not have complete access to laboratory values such as HbA1c levels. Blood sugar control before and during pregnancy may affect outcomes independently of medication use.
Most women in the continuation group only had brief exposure during the first trimester. The study provides less information about prolonged exposure throughout pregnancy.
Because major congenital malformations and some growth abnormalities are relatively uncommon, larger studies are needed to produce more precise risk estimates.
Women who are planning a pregnancy should discuss GLP-1 medications with their healthcare provider well in advance. Current manufacturer recommendations generally advise discontinuing these drugs before conception.
However, if pregnancy occurs unexpectedly while taking a GLP-1 medication, this new research suggests there may not be a substantial increase in the risk of miscarriage, birth defects, or abnormal fetal growth from early exposure.
The best course of action is to contact an obstetrician, endocrinologist, or healthcare provider promptly to review individual risks and determine the most appropriate treatment plan.
The growing use of GLP-1 receptor agonists has created an urgent need for reliable pregnancy safety data. This large U.S. study contributes important evidence by examining more than 3,500 pregnancies among women who used these medications around the time of conception.
Researchers found no indication of a strong increase in the risk of nonlive birth, major congenital malformations, or abnormal fetal growth when GLP-1 medications were continued into the first trimester. While uncertainty remains and additional studies are needed, the findings provide reassurance for women who experience unintentional early pregnancy exposure.
As more data become available, healthcare professionals will be better equipped to guide patients on the safest use of GLP-1 therapies before and during pregnancy.
Brown JP, Huybrechts KF, Straub L, Patorno E, Seely EW, Bateman BT, Hernández-Díaz S. Continuing Glucagon-Like Peptide-1 Receptor Agonists Into the First Trimester of Pregnancy and Pregnancy Outcomes: A Target Trial Emulation Study Using Claims Information. Annals of Internal Medicine, June 2026.
This article is intended for educational and informational purposes only and should not be considered medical advice. The findings summarized here are based on observational research and do not establish cause and effect. Individuals who are pregnant, planning pregnancy, or currently using GLP-1 medications should consult a qualified healthcare professional before making any treatment decisions.
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