S'abonner

Glucagon-like peptide-1 receptor agonist use in pregnancy: a review - 24/12/24

Doi : 10.1016/j.ajog.2024.08.024 
Rosa F. Drummond, MD , Karl E. Seif, MD, E. Albert Reece, MD, PhD, MBA
 Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine and Medical Center, Baltimore, MD 

Corresponding author: Rosa F. Drummond, MD.

Abstract

Glucagon-like peptide-1 receptor agonists are peptide analogues that are used to treat type 2 diabetes mellitus and obesity. The first medication in this class, exenatide, was approved in 2005, and these medications, specifically semaglutide, have become more popular in recent years due to their pronounced effects on glycemic control, weight reduction, and cardiovascular health. Due to successful weight loss from these medications, many women previously diagnosed with oligomenorrhea and unable to conceive have experienced unplanned pregnancies while taking the medications. However, there are currently little data for clinicians to use in counseling patients in cases of accidental periconceptional exposure.

In some studies examining small animals exposed to glucagon-like peptide-1 receptor agonists in pregnancy, there has been evidence of adverse outcomes in the offspring, including decreased fetal growth, skeletal and visceral anomalies, and embryonic death. Although there are no prospective studies in humans, case reports, cohort studies, and population-based studies have not shown a pattern of congenital anomalies in infants. A recent large, observational, population-based cohort study examined 938 pregnancies affected by type 2 diabetes mellitus and compared outcomes from periconceptional exposure to glucagon-like peptide-1 receptor agonists and insulin. The authors concluded there was not a significantly increased risk of major congenital malformations in patients taking glucagon-like peptide-1 receptor agonists, although there was no information on maternal glycemic control or diabetic fetopathy. As diabetic embryopathy is directly related to the degree of maternal hyperglycemia and not the diagnosis of diabetes itself, it is not possible to make this conclusion without this information. Furthermore, there is little evidence available regarding fetal growth restriction, embryonic or fetal death, or other potential complications. At this time, patients should be counseled there is not enough evidence to predict any adverse effects, or the lack thereof, of periconceptional exposure of glucagon-like peptide-1 receptor agonists during pregnancy. We recommend that all patients use contraception to prevent unintended pregnancy while taking glucagon-like peptide-1 receptor agonists.

Le texte complet de cet article est disponible en PDF.

Video


(8.99 Mo)

Le texte complet de cet article est disponible en PDF.

Key words : abortion, diabetic fetopathy, dulaglutide, embryonic death, exenatide, fetal anomalies, fetal death, fetal growth restriction, glucagon-like peptide-1 receptor agonists, glycemic control, hyperglycemia, insulin resistance, liraglutide, lixisenatide, major congenital malformations, miscarriage, obesity, PCOS, periconceptional use, semaglutide, teratogenicity, tirzepatide, type 2 diabetes, unplanned pregnancy, weight loss


Plan


 The authors report no conflict of interest.
 There are no sources of financial support to disclose.


© 2024  Elsevier Inc. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 232 - N° 1

P. 17-25 - janvier 2025 Retour au numéro
Article précédent Article précédent
  • A Lexicon for First-Trimester US: Society of Radiologists in Ultrasound Consensus Conference Recommendations
  • Shuchi K. Rodgers, Mindy M. Horrow, Peter M. Doubilet, Mary C. Frates, Anne Kennedy, Rochelle Andreotti, Kristyn Brandi, Laura Detti, Sarah K. Horvath, Aya Kamaya, Atsuko Koyama, Penelope Chun Lema, Katherine E. Maturen, Tara Morgan, Sarah G. Običan, Kristen Olinger, Roya Sohaey, Suneeta Senapati, Lori M. Strachowski
| Article suivant Article suivant
  • Time to redefine prolonged third stage of labor? A systematic review and meta-analysis of the length of the third stage of labor and adverse maternal outcome after vaginal birth
  • Pauline L.M. de Vries, Emma Veenstra, David Baud, Hélène Legardeur, Athanasios F. Kallianidis, Thomas van den Akker

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.


Tout le contenu de ce site: Copyright © 2025 Elsevier, ses concédants de licence et ses contributeurs. Tout les droits sont réservés, y compris ceux relatifs à l'exploration de textes et de données, a la formation en IA et aux technologies similaires. Pour tout contenu en libre accès, les conditions de licence Creative Commons s'appliquent.