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In this installment of Med Op-Ed: A call to study the effects of GLP-1 receptor agonists on pregnancy outcomes; the public health promise of light physical activity; and what treadmill testing reveals in asymptomatic aortic stenosis.
A Need for GLP-1 Pregnancy Data
Guidelines advise against the use of GLP-1 receptor agonists during pregnancy, but many infants may be unintentionally exposed to the medications in the first trimester — including tens of thousands of children in the UK in 2026 alone, estimated Adrian Heald, DM, BM, BCh, MA, and colleagues in BMJ. More data are needed to better understand how exposure to the drugs might influence pregnancy outcomes, they wrote.
The Context
- Many women use GLP-1 receptor agonists such as semaglutide and tirzepatide for weight loss. These drugs may increase the likelihood of unplanned pregnancy by reducing the effectiveness of oral contraceptives or restoring ovulation in conditions like polyendocrine metabolic ovarian syndrome.
- A recent survey of 61 UK healthcare professionals found 67% had encountered patients who conceived while taking GLP-1 receptor agonists.
- To help address data gaps, researchers should ask patients about the use of weight-loss medications during routine prenatal questionnaires, measure GLP-1 concentrations in blood samples, and compare maternal and fetal outcomes for exposed cohorts and matched controls, the authors suggested.
In Their Own Words
“Many health professionals are uncertain about what to monitor in women who are pregnant and taking GLP-1 receptor agonists and are also unclear on what to communicate to the patient.”
Read it: Pregnancy Outcomes of GLP-1 Exposure in the First Trimester: Data Gathering in Early Pregnancy Would Inform on Areas of Uncertainty
Is Light Activity a Missing Link in Public Health?
Light-intensity physical activity — such as standing while doing the dishes — accounts for roughly half of daily physical activity energy expenditure yet has historically been neglected in public health guidelines, according to Stephanie A. Prince, PhD, with Public Health Agency of Canada and the University of Ottawa, Ottawa, Ontario, Canada, and colleagues writing in the British Journal of Sports Medicine.
The Context
- With average sedentary time increasing and amounts of moderate-to-vigorous physical activity remaining stable, light activity may be an approachable target for population-level health improvements, particularly for people with physical limitations or preferences for lower-intensity movement.
- Research has shown that replacing 30 min/d of sitting with standing or light activity may lower cardiovascular risk. Another study found the health benefits from 53-156 minutes of light activity may be roughly equivalent to those from 1 minute of vigorous activity.
- Further research is needed to define optimal doses and intensity thresholds of light physical activity, the editorialists write.
In Their Own Words
“Evidence consistently shows that any increase in [physical activity], especially shifting from ‘nothing to something,’ reduces morbidity and mortality risk among the least active.”
Have Asymptomatic Patients Just Adapted to Decline?
The absence of reported symptoms by patients with severe aortic stenosis might reflect patients’ gradual adaptation to and normalization of physical limitations, rather than physiologic reserve, according to Erwan Donal, MD, PhD, and colleagues writing in JAMA Cardiology.
The Context
- In a treadmill substudy of the EARLY TAVR trial, approximately 15% of patients considered asymptomatic had an abnormal exercise test, with exertional symptoms, hypotensive response, or arrhythmias.
- Although these patients had findings that would generally lead to referral for aortic valve replacement, nearly 20% had not been treated at 1 year.
- Risk assessments that integrate exercise testing, imaging, and biomarkers are crucial for identifying patients with severe aortic stenosis who may benefit from treatment, the authors wrote.
In Their Own Words
“Perhaps the most concerning finding is not that 15% of patients had an abnormal exercise test. Rather, it is that objective identification of an indication for intervention did not consistently translate into treatment.”
Read it: Exercise Testing and the Evolving Management of Asymptomatic Severe Aortic Stenosis
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
