To review pregnancy outcomes in women exposed to semaglutide during early pregnancy.
Methods
A retrospective review of an obstetric database at a tertiary obstetric hospital in Brisbane, Australia.
Results
Thirteen women were exposed to semaglutide in first trimester. One infant had significant cardiac anomalies in the setting of very poor maternal glycaemic control in first trimester, as well as maternal obesity and hypertension.
Conclusion
This study adds to the growing literature suggesting there is no increased risk of major congenital anomalies following first trimester exposure to semaglutide, however, until larger studies are available to confirm these findings, reproductive-age women using semaglutide should practice effective contraceptive methods. Preconception counselling of all women with diabetes mellitus is critical to avoid adverse pregnancy outcomes.
ZhengZZongYMaY, et al.Glucagon-like peptide-1 receptor: mechanisms and advances in therapy. Signal Transduct Target Therap2024; 9: 1–29.
2.
LeeMSattarMPop-BusuiR, et al.Cardiovascular and kidney outcomes and mortality with long-acting injectable and oral glucagon-like peptide 1 receptor agonists in individuals with type 2 diabetes: a systematic review and meta-analysis of randomized trials. Diabetes Care2025; 48(5): 846–859.
3.
IImbroaneMRLeMoineFNauCT. Preconception glucagon-like peptide-1 receptor agonist use associated with decreased risk of adverse obstetrical outcomes. Am J Obstet Gynecol2025. DOI: 10.1016/j.ajog.2025.01.019
4.
CestaCERotemRBatemanBT, et al.Safety of GLP-1 receptor agonists and other second-line antidiabetics in early pregnancy. JAMA Intern Med2024; 184: 144–152.
Australian Bureau of Statistics. Gender indicators, Australia, Jan 2012. Overweight/Obesity. Key Series. Cat. No. 4364.0.2012. Available from: www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4125.0∼Jan%202012∼Main%20Features∼Overweight%20and%20obesity∼3330#:∼:text=In%202007-08%2C%20a%20higher%20proportion%20of%20males%20aged,based%on%20people%27s%20self%20reported%20height%20and%20weight. Accessed 9th December 2024.
MullerDRPStenversDJMalekzadehA, et al.Effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidence. Front Endocrinol (Lausanne)2023; 14: 1215356.
10.
UK Teratology Information Service. Best use of medicines in pregnancy. Available from: www.medicinesinpregnancy.org. Accessed 9th December 2024.
11.
MaslinKAlkutbeRGilbertJ, et al.What is known about the use of weight loss medication in women with overweight/obesity on fertility and reproductive health outcomes? A scoping review. Clin Obes2024; 14: e12690.
12.
National Center for Biotechnology Information. Drugs and Lactation Database (Lactmed). Available from: www.ncbi.nlm.nih.gov/books/NBK501922/ Accessed 9th December 2024.
13.
NuakoATuLReyesKJC, et al.Pharmacologic treatment of obesity in reproductive aged women. Curr Obstet Gynecol Rep2023; 12: 138–146.
14.
IvanisevicMHMHorvaticekMLovrencicM,et al.Pregnancy outcome and liraglutide levels in serum and umbilical vein blood of a woman with type 2 diabetes. A case report. Gynaecol Perinatol2018; 27: 70–72.
15.
HilesRABawdonREPetrellaEM. Ex vivo human placental transfer of the peptides pramlintide and exenatide (synthetic exendin-4). Hum Exp Toxicol2003; 22: 623–628.
16.
GrecoD. Normal pregnancy outcome after first-trimester exposure to liraglutide in a woman with type 2 diabetes. Diabet Med2015; 32: e29–e30.
17.
BurlinaSDalfraMGCaprinoR,et al.A case report on use of dulaglutide during the first weeks of pregnancy in woman affected by type 2 diabetes mellitus. Acta Diabetol2023; 60: 137–138.
18.
AlghamdiAAlsaeddiAMalkiH,et al.A case report of a pregnant woman with type 2 diabetes mellitus using dulaglutide during the first trimester of pregnancy. Cureus2023; 15: e44644.
19.
SkovKMandicINNyborgKM. Semaglutide and pregnancy. Int J Gynaecol Obstet2023; 163(2): 699‒700.
20.
Williams JPNPop-BusuiRLashR, et al. Exenatide use during pregnancy. The Endocrinologist2009; 19: 119–21.
21.
DaoKShechtmanSWeber-SchoendorferC, et al. 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. BMJ Open2024; 14(4): e083550.
22.
TripathiARankinJAarvoldJ, et al. Preconception counseling in women with diabetes: a population-based study in the north of England. Diabetes Care2010; 33: 586–588.
23.
Roberts ASKStaffordJet al. Preconception counselling in women with diabetes: SEARCH for diabetes in youth study. Diabetes2021; 70 (Supplement 1): 963.
24.
JanzNKHermanWHBeckerMP, et al. Diabetes and pregnancy. Factors associated with seeking pre-conception care. Diabetes Care1995; 18: 157–165.
25.
MarshallCJParhamLHubbardE, et al. Experiences of preconception counseling among pregnant women with preexisting diabetes: opportunities to improve patient-centered care. Int J Environ Res Public Health2023. DOI: 10.3390/ijerph20042908
26.
HolmesVAHamillLLAlderdiceFA, et al. Effect of implementation of a preconception counselling resource for women with diabetes: A population based study. Prim Care Diabetes2017; 11: 37–45.
27.
CallecRPerdriolle-GaletESeryGA, et al. Type 2 diabetes in pregnancy: Rates of fetal malformations and level of preconception care. J Obstet Gynaecol2014; 34: 648–649.
