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Periconceptional GLP-1 receptor agonist exposure and obstetric outcomes:a Danish nationwide cohort study

Title: Periconceptional GLP-1 receptor agonist exposure and obstetric outcomes:a Danish nationwide cohort study
Authors: Hviid, Kathrine Vauvert R.; Banasik, Karina; Mortensen, Laust Hvas; Madsbad, Sten; Strandberg-Larsen, Katrine; Geiker, Nina Rica Wium; Westergaard, David; Nielsen, Henriette Svarre
Source: Hviid , K V R , Banasik , K , Mortensen , L H , Madsbad , S , Strandberg-Larsen , K , Geiker , N R W , Westergaard , D & Nielsen , H S 2026 , ' Periconceptional GLP-1 receptor agonist exposure and obstetric outcomes : a Danish nationwide cohort study ' , Human Reproduction Open , vol. 2026 , no. 2 , hoag015 . https://doi.org/10.1093/hropen/hoag015
Publication Year: 2026
Collection: University of Copenhagen: Research / Forskning ved Københavns Universitet
Subject Terms: GLP-1 receptor agonist; Diabetes; Liraglutide; Obesity; Periconceptional exposure; Pregnancy; Preterm birth; Semaglutide
Description: STUDY QUESTION What is the association between periconceptional GLP-1 receptor agonist exposure and risk of obstetric complications?SUMMARY ANSWER Periconceptional GLP-1 receptor agonist exposure was associated with increased preterm birth risk when used for diabetes treatment (liraglutide aOR 1.70, 95% CI 1.17-2.48; semaglutide aOR 1.84, 95% CI 1.24-2.7) but not for weight management, suggesting the underlying diabetes rather than the medication may be the causal factor.WHAT IS KNOWN ALREADY GLP-1 receptor agonists are rapidly expanding in use among reproductive-age women for diabetes and obesity treatment. While not approved for use in pregnancy, inadvertent periconceptional exposure occurs frequently. Limited safety data exist, with recent small studies suggesting no increased risk of major congenital malformations, but comprehensive obstetric outcome data remain lacking.STUDY DESIGN, SIZE, DURATION This nationwide observational cohort study used data from Danish health registries from October 2009 through December 2023. We analyzed 756 636 singleton pregnancies among 480 231 women, with 529 pregnancies having periconceptional GLP-1 receptor agonist exposure.PARTICIPANTS/MATERIALS, SETTING, METHODS We identified periconceptional liraglutide or semaglutide exposure (prescription redemption within 8 weeks before/after last menstrual period) using the National Prescription Register. Exposed pregnancies were stratified by maternal pre-existing diabetes status and compared with propensity score-matched unexposed controls. Propensity score matching incorporated maternal age, BMI, smoking, geographic region, education, pre-existing diabetes, parity, and temporal factors.MAIN RESULTS AND THE ROLE OF CHANCE Before adjustment, exposed women had higher rates of multiple obstetric complications. After propensity score matching, only the risk of preterm birth remained elevated for exposed women. This increased risk was confined to women using GLP-1 receptor agonists for diabetes treatment (liraglutide aOR 1.70, 95% CI ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
DOI: 10.1093/hropen/hoag015
Availability: https://researchprofiles.ku.dk/da/publications/428fe2e4-d164-42d0-b397-a37252168829; https://doi.org/10.1093/hropen/hoag015; https://curis.ku.dk/ws/files/539671097/hoag015.pdf
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.A44F201B
Database: BASE