A Retrospective Cohort Study of GLP-1 receptor agonist therapy in pregnant women with insulin resistance
Authors/Creators
- 1. Brahmaputra Institute for Advanced Metabolic Disease
- 2. Colorado Institute for Advanced Diabetes and Endocrinology
- 3. Clyde Research Center for Metabolic Disease
Description
Background/Objective: GLP-1RA are widely prescribed to insulin-resistant women of reproductive age but are not recommended in pregnancy; we compared outcomes by discontinuation timing after conception [1,13].
Methods: Retrospective cohort of 248 pregnant women with insulin resistance prescribed a GLP-1RA before conception at three centers, 2018-2023, comparing early discontinuation (≤4 weeks, n=164) with continued exposure (>4 weeks, n=84) [16].
Results: Continued exposure showed higher third-trimester HbA1c (6.0% vs 5.7%), gestational diabetes (33.3% vs 28.7%), preeclampsia (14.3% vs 9.1%), and NICU admission (21.4% vs 15.2%); congenital anomaly rates were low and similar (3.6% vs 2.4%) [13,29].
Conclusions: Prompt GLP-1RA discontinuation was associated with more favorable outcomes, supporting guidance to discontinue GLP-1RA before conception and substitute insulin or metformin in pregnancy [11,24].