TOPLINE

Exposure to GLP-1 receptor agonists (GLP-1 RAs) during the preconception period or first trimester was not significantly associated with an increased risk for hypertensive disorders of pregnancy (HDP) in a meta-analysis of more than 10,000 pregnancies.

METHODOLOGY

• Researchers conducted a systematic review and meta-analysis to examine the association between GLP-1 RA exposure before conception or during the first trimester and risk for HDP.
• They searched five databases and included three retrospective cohort studies conducted in the US between 2014 and 2025.
• A total of 10,880 pregnancies were included: 4942 exposed to GLP-1 RAs (semaglutide, albiglutide, liraglutide, tirzepatide, dulaglutide, exenatide, or lixisenatide) and 5938 unexposed control pregnancies.
• Exposure timing ranged from up to 36 months before conception to the first trimester of pregnancy.
• Researchers pooled odds ratios (ORs) and assessed risk for bias and heterogeneity (I²).

TAKEAWAY

• The pooled analysis showed no statistically significant association between GLP-1 RA exposure and risk for HDP (odds ratio [OR], 0.91; P = .70).
• Two studies reported lower risks for HDP among exposed pregnancies, while one study found a higher risk, with substantial heterogeneity across studies (I² = 94%).
• HDP prevalence among GLP-1 RA-exposed pregnancies ranged from 19.9% to 46.3% across the three studies.
• All three studies were judged to have moderate overall risk for bias.

IN PRACTICE

"GLP-1 RAs therapy may provide a potent preconception support for the women with obesity and type 2 diabetes... Prospective trials are needed to quantify these risks and to build clinical strategies aimed to improve perinatal outcomes in high risk categories," the authors of the study wrote.

SOURCE

The study was led by Davide Pisani, Department of Woman, University of Campania "Luigi Vanvitelli" in Naples, Italy. It was published online on July 31 in Endocrine.

LIMITATIONS

All studies were retrospective and observational, limiting causal inference. Reliance on diagnostic codes may have led to misclassification or underreporting of HDP. The analysis was restricted to studies from the US, potentially limiting generalizability to other populations.

DISCLOSURES

The study received open access funding from Università degli Studi della Campania Luigi Vanvitelli. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.