News | Are GLP-1 Drugs Safe for Women Planning Pregnancy? New Australian Study Raises Concerns
A new study in the Medical Journal of Australia has raised concern as more women of reproductive age use GLP-1 receptor agonists (GLP-1 RAs) for weight management or type 2 diabetes without effective contraception, potentially increasing the risks of unintended pregnancy and fetal exposure.
What are GLP-1 RAs, and why are they popular?
GLP-1 receptor agonists mimic the natural hormone GLP-1 and stimulate insulin release when blood glucose rises. Originally used for type 2 diabetes, they are now widely prescribed off-label for weight management because of their significant weight-loss effects, especially in people without diabetes.
In 2022, as many as 91% of Australian women of reproductive age prescribed GLP-1 RAs did not have type 2 diabetes, reflecting the drugs’ popularity for weight loss among younger women.
Use has surged, but contraception has lagged
The study included 1,635,684 women aged 18 to 49, of whom 18,010 received a first GLP-1 RA prescription. In 2022, 6,954 women received a prescription, but only 21% of the sample had complete electronic health records for tracking contraception.
Among these women, only 17% with diabetes and 23% without diabetes were using contraception when they started GLP-1 RAs. Long-acting reversible contraception (LARC) use was still lower at 6% and 9%, respectively, below the 11% rate among Australian women overall.
During the study, 232 pregnancies occurred within six months of treatment. Women not using contraception had a higher pregnancy risk, while contraception during GLP-1 RA use reduced the likelihood of pregnancy within six months by 40%.
Younger women, obesity, and PCOS as higher-risk groups
About 4% of women aged 18-29 with type 2 diabetes became pregnant within six months, the highest proportion among all age groups. Among women without diabetes, pregnancy was most common at ages 30-34 (6%).
Polycystic ovary syndrome (PCOS) was twice as common among those who became pregnant as among those who did not, highlighting reproductive considerations during GLP-1 RA use.
Are these drugs safe during pregnancy? The answer remains uncertain
Some animal studies suggest that GLP-1 drugs may cause fetal growth restriction, skeletal abnormalities, delayed ossification, and insufficient maternal weight gain, but human research remains limited. A large 2024 population study of 938 pregnancies found no significant increase in major fetal malformations with GLP-1 drugs compared with insulin.
However, current data do not cover other key outcomes such as preterm birth, fetal growth restriction, and pregnancy complications, so other adverse effects cannot be excluded.
The UK has clear guidance; Australia needs stronger oversight
UK national guidance states that GLP-1 drugs must not be used during pregnancy and that women of reproductive age should use effective contraception during treatment. Australian practice currently lags behind.
The study calls for clearer, systematic clinical guidance to ensure safe, appropriate GLP-1 RA use in women of reproductive age, especially those with diabetes, obesity, or PCOS.
Market approval and promotion driving growth
Prescriptions have risen sharply since the GLP-1 drug semaglutide was approved and listed on the Pharmaceutical Benefits Scheme (PBS) in 2020, accelerating its uptake among younger women.
Pregnancy risk management remains essential as these drugs grow in popularity.
News | Are GLP-1 Drugs Safe for Women Planning Pregnancy? New Australian Study Raises Concerns
News | Are GLP-1 Drugs Safe for Women Planning Pregnancy? New Australian Study Raises Concerns
A new study in the Medical Journal of Australia has raised concern as more women of reproductive age use GLP-1 receptor agonists (GLP-1 RAs) for weight management or type 2 diabetes without effective contraception, potentially increasing the risks of unintended pregnancy and fetal exposure.
What are GLP-1 RAs, and why are they popular?
GLP-1 receptor agonists mimic the natural hormone GLP-1 and stimulate insulin release when blood glucose rises. Originally used for type 2 diabetes, they are now widely prescribed off-label for weight management because of their significant weight-loss effects, especially in people without diabetes.
In 2022, as many as 91% of Australian women of reproductive age prescribed GLP-1 RAs did not have type 2 diabetes, reflecting the drugs’ popularity for weight loss among younger women.
Use has surged, but contraception has lagged
The study included 1,635,684 women aged 18 to 49, of whom 18,010 received a first GLP-1 RA prescription. In 2022, 6,954 women received a prescription, but only 21% of the sample had complete electronic health records for tracking contraception.
Among these women, only 17% with diabetes and 23% without diabetes were using contraception when they started GLP-1 RAs. Long-acting reversible contraception (LARC) use was still lower at 6% and 9%, respectively, below the 11% rate among Australian women overall.
During the study, 232 pregnancies occurred within six months of treatment. Women not using contraception had a higher pregnancy risk, while contraception during GLP-1 RA use reduced the likelihood of pregnancy within six months by 40%.
Younger women, obesity, and PCOS as higher-risk groups
About 4% of women aged 18-29 with type 2 diabetes became pregnant within six months, the highest proportion among all age groups. Among women without diabetes, pregnancy was most common at ages 30-34 (6%).
Polycystic ovary syndrome (PCOS) was twice as common among those who became pregnant as among those who did not, highlighting reproductive considerations during GLP-1 RA use.
Are these drugs safe during pregnancy? The answer remains uncertain
Some animal studies suggest that GLP-1 drugs may cause fetal growth restriction, skeletal abnormalities, delayed ossification, and insufficient maternal weight gain, but human research remains limited. A large 2024 population study of 938 pregnancies found no significant increase in major fetal malformations with GLP-1 drugs compared with insulin.
However, current data do not cover other key outcomes such as preterm birth, fetal growth restriction, and pregnancy complications, so other adverse effects cannot be excluded.
The UK has clear guidance; Australia needs stronger oversight
UK national guidance states that GLP-1 drugs must not be used during pregnancy and that women of reproductive age should use effective contraception during treatment. Australian practice currently lags behind.
The study calls for clearer, systematic clinical guidance to ensure safe, appropriate GLP-1 RA use in women of reproductive age, especially those with diabetes, obesity, or PCOS.
Market approval and promotion driving growth
Prescriptions have risen sharply since the GLP-1 drug semaglutide was approved and listed on the Pharmaceutical Benefits Scheme (PBS) in 2020, accelerating its uptake among younger women.
Pregnancy risk management remains essential as these drugs grow in popularity.
Source:
Collected online