Preconception use of GLP-1 Receptor Agonists tied to Lower Pregnancy Risks reveals research
Researchers have found in a new study that Use of GLP-1 receptor agonists before pregnancy was associated with reduced risks of hypertensive disorders, gestational diabetes, preterm birth, and cesarean delivery. Further women prescribed GLP-1 receptor agonists up to two years before conception were less likely to experience these complications. The findings were published in the American Journal of Obstetrics and Gynecology.
The use of glucagon-like-peptide-1 receptor agonists (GLP-1RAs) has greatly increased in patients of reproductive age within the past four years. However, there is minimal research into the long-term impact of these medications on future pregnancies. They aimed to evaluate the association between adverse obstetric outcomes and antecedent GLP-1RA use using a nationally representative database.
They conducted a retrospective cohort study of female patients age ≥ 18 using the United States Collaborative Network in TriNetX. We defined the exposure cohort as individuals who received a GLP-1RA prescription within 2 years preceding a pregnancy. The unexposed cohort comprised individuals with a history of pregnancy but no prior history of GLP-1RA use. Cohorts were matched for age, race, ethnicity, and history of co-morbid conditions. ICD-10 codes for hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), preterm delivery, and rates of Cesarean section (CD) were the primary outcomes of interest compared between the cohorts. Logistic regression was performed in TriNetX to determine odds ratios (OR) and 95% confidence intervals (CI).
Results: After matching, there were 4,267 individuals in each cohort. Individuals who had a prescription for GLP-1RA were less likely to develop GDM (15.2% versus 18.2%, OR 0.81 (95% CI 0.72,0.91)), HDP (19.9% versus 22.8%, OR 0.84 (0.76,0.94)), have a preterm delivery (3.0% vs 4.4%, OR 0.68 (0.54,0.85)), and undergo a CD (17.6% vs 19.7%, OR 0.89 (0.87,0.97)) compared to the unexposed cohort.
A prescription of a GLP-1RA within 24 months preceding pregnancy is associated with a reduced risk of several adverse obstetric outcomes, including GDM, HDP, preterm delivery, and CD.
This is suggestive that use of a GLP-1RA may be a powerful tool to improve perinatal outcomes in high-risk populations, though future work is required to define how this class of medication is best incorporated clinically into preconception health optimization.
Reference:
Preconception GLP-1 Receptor Agonist Use Associated with Decreased Risk for Adverse Obstetric Outcomes. Imbroane, Marisa R. et al. American Journal of Obstetrics & Gynecology, Volume 0, Issue 0
