USE OF GLP1 RECEPTOR AGONISTS IN EARLY PREGNANCY AND REPRODUCTIVE SAFETY: A MULTICENTRE, OBSERVATIONAL, PROSPECTIVE COHORT STUDY BASED ON THE DATABASES OF SIX TERATOLOGY INFORMATION SERVICES

Use of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six Teratology Information Services

Use of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six Teratology Information Services

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Tank Kit Objectives Glucagon-like peptide 1 receptor agonists (GLP1-RA) are indicated for the treatment of type 2 diabetes and more recently for weight loss.The aim of this study was to assess the risks associated with GLP1-RA exposure during early pregnancy.Design This multicentre, observational prospective cohort study compared pregnancy outcomes in women exposed to GLP1-RA in early pregnancy either for diabetes or obesity treatment with those in two reference groups: (1) women with diabetes exposed to at least one non-GLP1-RA antidiabetic drug during the first trimester and (2) a reference group of overweight/obese women without diabetes, between 2009 and 2022.Setting Data were collected from the databases of six Teratology Information Services.Participants This study included 168 pregnancies of women exposed to GLP1-RA during the first trimester, alongside a reference group of 156 pregnancies of women with diabetes and 163 pregnancies of overweight/obese women.

Results Exposure to GLP1-RA in the first trimester was not associated with a risk of major birth defects when compared with diabetes (2.6% vs 2.3%; adjusted OR, 0.98 (95% CI, 0.16 to 5.

82)) or to overweight/obese (2.6% vs 3.9%; adjusted OR 0.54 (0.11 to 2.

75)).For the GLP1-RA group, cumulative incidence for live births, pregnancy losses and pregnancy terminations was 59%, 23% and 18%, respectively.In the diabetes reference group, corresponding estimates were 69%, 26% and 6%, while in the overweight/obese reference group, they were 63%, 29% and 8%, respectively.Cox proportional cause-specific hazard models indicated no increased risk of pregnancy losses in the GLP1-RA versus the diabetes and the overweight/obese Wooden Train Set reference groups, in both crude and adjusted analyses.Conclusions This study offers reassurance in cases of inadvertent exposure to GLP1-RA during the first trimester of pregnancy.

Due to the limited sample size, larger studies are required to validate these findings.

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