GLP-1 Discontinuation Before Pregnancy Linked to Increased Weight Gain and Complications

Pregnant individuals who discontinued popular GLP-1 (搜索)搜索该药品 weight loss medications before or early in pregnancy experienced significantly more weight gain and pregnancy complications compared to those who never used these drugs, according to new research from Mass General Brigham (搜索)搜索该词条 published in JAMA.

The study analyzed electronic health records for 1,792 pregnancies delivered within the Mass General Brigham (搜索)搜索该词条 healthcare system between 2016-2025, primarily among women with obesity (搜索)搜索该疾病. Each woman with a GLP-1 (搜索)搜索该药品 receptor agonist prescription within three years before and up to 90 days after conception was matched to three similar pregnancies where the mother did not use GLP-1s.

Significant Weight Gain and Pregnancy Risks

Individuals who stopped GLP-1s before or in early pregnancy gained an average of 7.2 pounds more weight during pregnancy than those who did not use the weight loss drugs. The GLP-1 (搜索)搜索该药品 group demonstrated multiple elevated risks:

• 32% higher risk of excess weight gain (gaining more than recommended)
• 30% higher risk of diabetes during pregnancy
• 29% higher risk of hypertensive disorders during pregnancy
• 34% higher risk of preterm delivery

"The use of glucagon-like peptide-1 receptor agonists (搜索)搜索该药品-or GLP-1RAs-has increased dramatically, but recommendations suggest their discontinuation before pregnancy because there's not enough information about their safety for unborn babies," said lead author Dr. Jacqueline Maya, a pediatric endocrinologist at Mass General Brigham (搜索)搜索该词条 for Children.

Study Population and Methodology

The research focused on approximately 450 pregnancies where mothers used GLP-1s between three years before and 90 days after conception. About 50% stopped taking the medications within six months of conception, 34% stopped earlier, and 17% stopped after conception. Just prior to pregnancy, the average BMI of these mothers was about 36, categorized as obese.

Those in the GLP-1 (搜索)搜索该药品-treated group gained more weight during pregnancy—about 30 pounds on average, compared with 23 pounds for the comparison group. Notably, 65% of the GLP-treated group had "excessive" weight gain compared with 49% of the comparison group.

Clinical Implications and Study Limitations

The timing of GLP-1 (搜索)搜索该药品 stoppage within the treated group didn't significantly affect the results. "We expected, I think, a more pronounced change, but our results were pretty similar," Maya noted.

However, the study had key limitations. The researchers compared people who had taken GLP-1s with people of similar body mass who had never been on the drugs, looking at the treated group only after they were exposed to GLP-1s when their BMIs had likely fallen lower than their pre-prescription weights.

Need for Further Research

"Additional studies are needed on the balance of pre-pregnancy benefits of GLP-1s with the risks associated with interrupting them for pregnancy," said senior author Dr. Camille E. Powe, a Mass General Brigham (搜索)搜索该词条 endocrinologist and co-director of the Diabetes (搜索)搜索该疾病 in Pregnancy Program at Massachusetts General Hospital查看公司主页.

The findings contradict some previous research that linked GLP-1 (搜索)搜索该药品 use to lower risk of hypertensive disorders (搜索)搜索该疾病 of pregnancy, possibly because those studies included more people prescribed GLP-1s for diabetes (搜索)搜索该疾病 rather than obesity (搜索)搜索该疾病.

"We need to do more research to find ways to help manage weight gain and reduce risks during pregnancy when stopping GLP-1 (搜索)搜索该药品 medications," Powe added. Currently, there is "limited or no clinical guidance" on the use of GLP-1s prior to conception, highlighting the critical need for evidence to inform obstetric care and treatment decisions.