Women who accidentally fall pregnant while taking a GLP-1 treatment for diabetes or weight loss are not at increased risk of miscarriage or other complications of pregnancy, reports Nursing Times.
A systematic review and meta-analysis by British researchers found that taking Mounjaro, Ozempic or Wegovy in the six months before pregnancy was not associated with any major pregnancy complications, while babies born to mothers exposed to GLP-1s before pregnancy were also no more likely than others to suffer adverse outcomes.
Current guidance from the Medicines and Healthcare products Regulatory Agency (MHRA) states that GLP-1 medications should not be taken during pregnancy or when trying to conceive – the guidance being based on data from animal studies that suggested GLP-1s could cause harm to the unborn foetus, plus a lack of safety information about the effect of the drugs on pregnant women and babies.
Current recommendations are that anyone on the GLP-1 semaglutide (Wegovy, Ozempic or Rybelsus) should stop taking the treatment at least two months before pregnancy.
Tirzepatide (Mounjaro) should be stopped at least one month before pregnancy, the MHRA guidance states.
However, the new review’s results found reassuring evidence that women who inadvertently become pregnant while taking a GLP-1 are not at higher risk of adverse pregnancy outcomes.
The analysis included data from more than 2.1m pregnancies, including 8 325 pregnancies where the mother had been exposed to a GLP-1 within six months before a positive pregnancy test.
The study findings, published in the journal Med, found that GLP-1 exposure around conception was not linked to any increase in the risk of problems or negative outcomes – and this included miscarriage, stillbirth, congenital anomalies, preterm birth, gestational diabetes, high blood pressure disorders of pregnancy, excessive maternal weight gain or babies being unusually small or large at birth.
One of the study’s authors, Professor Asma Khalil, from City St George’s, University of London, said it was still important to follow the advice to discontinue GLP-1 treatment before pregnancy, but that the results from were “reassuring” for women who may have accidentally become pregnant while taking one of the drugs.
“However, it is important to stress that our findings do not establish that these medications are safe during pregnancy. The evidence remains observational, and current recommendations to discontinue GLP-1 receptor agonists before a planned pregnancy should continue to be followed,” she added.
Study details
GLP-1 receptor agonist exposure in the periconceptional period and adverse obstetric outcomes: A systematic review and meta-analysis
Francesco D'Antonio, Maria Elena Flacco, Lamberto Manzoli, Athina Samara, Asma Khalil.
Published in Med on 29 September 2026
Summary
Background
This systematic review and meta-analysis assesses whether exposure to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) during pregnancy or the peri-conceptional period is associated with adverse maternal and perinatal outcomes.
Methods
Medline, Embase, and the Cochrane Library were searched for observational studies comparing pregnancies exposed and unexposed to GLP-1 RAs within six months before a positive pregnancy test. Outcomes included miscarriage, intrauterine death, congenital anomalies, preterm birth (PTB), hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), foetal growth restriction (FGR), small for gestational age (SGA), large for gestational age (LGA), and excess gestational weight gain. Random-effects meta-analyses and subgroup analyses by indication were performed.
Findings
Ten studies included 2,118,215 women, of whom 8 325 were exposed and 2 109 890 were unexposed. Pooled estimates did not show a clearly detectable increase in miscarriage or intrauterine death, congenital anomalies, preterm birth, HDP, gestational diabetes, abnormal foetal growth, or excess gestational weight gain. A lower pooled estimate for pre-eclampsia was observed (odds ratio [OR]: 0.87, 95% confidence interval [CI]: 0.78–0.98; p = 0.02), but this was based on two datasets and should be interpreted cautiously. Subgroup analyses showed no clearly detectable differences by indication. The exposure-window sensitivity analysis, covering 90 days before conception through the end of the first trimester, used the same four studies as the primary congenital-malformation analysis and therefore was not independent.
Conclusion
Available observational evidence did not identify a clearly detectable increase in adverse maternal or perinatal outcomes following peri-conceptional exposure to GLP-1 RAs. However, these findings do not establish safety because of heterogeneity, residual confounding, and limited datasets.
See more from MedicalBrief archives:
Weight-loss shots linked to unexpected pregnancies
GLP-1 drugs – how real are the risks?