GLP-1 Drugs and Babies, Part 2

Any factor with the potential to affect a baby throughout its entire lifetime is not a thing to be taken lightly. A number of authorities have something to say about the subject of GLP-1 drugs in conjunction with pregnancy.

Many media articles mention Ozempic, a drug which, because of its early and widespread popularity, seems to stand in for and take the fall for the whole group of similar meds. But that one preparation does not represent the entire range of risk. Another brand’s packaging, for instance, warns of increased risk to the fetus, of cleft lip and cleft palate.

The Food and Drug Administration states that no one should take GLP-1 drugs if they are trying to become pregnant. For those who are planning on motherhood and are on a GLP-1, the FDA recommends stopping the medication at least two months before trying to conceive.

Jamie Winn, Pharm.D., told journalist Cathy Cassata,

While no studies have been conducted on pregnant people taking GLP-1 drugs, studies in animals such as rats, rabbits, and monkeys showed that these animals experienced high rates of miscarriages when they were given an injectable GLP-1 medication. The babies the animals gave birth to were smaller in size than usual and with more birth defects.

Just to complicate matters, pregestational diabetes has long been known to “increase the risk for potential pregnancy, including birth defects, miscarriage, fetal growth restriction, premature labor, and preeclampsia.” Some professionals believe that so far, weight-loss drugs offer no greater risk than insulin, which pregnant women with diabetes have needed to take.

Still, clinical endocrinologist Dr. Sethu Reddy has said that no GLP-1 receptor agonist is “indicated for improving fertility” and that “risk can not be ruled out.” On the other hand, GLP-1 receptor agonists seem to perform no worse than insulin, and patient acceptability and adherence are great advantages.

But this only applies to the small percentage of potential mothers who must receive extra protection because of their diabetes. Dr. Sonia Hernández-Díaz is quoted as saying,

[T]he safety of these agents in pregnancy is largely unknown, as pregnant women are typically excluded from clinical trials; hence, treatment guidelines do not recommend these agents in pregnancy.

Around the same time, a Swedish study provided reassurance about the prenatal exposure experienced by fetuses when the mothers are treated for obesity with semaglutide. Only a month later, it was announced that a study of 50,000 pregnancies in six countries, followed up for the first year after birth, provided “reassuring” answers regarding the GLP-1 drugs. Still, even though they apparently post no greater risk than insulin, one year of follow-up cannot tell the whole story.

A researcher who wants to know everything about the effects these drugs have on mothers and their babies cannot simply round up a group of suitable female subjects and keep them on the premises, while hourly monitoring every body function. Nor can they even pay women who have used or are using the substances to turn themselves and their fetuses into lab specimens.

(To be continued…)

Your responses and feedback are welcome!

Source: “Ozempic’s Effects on Pregnancy and Fertility: Experts Answer 4 Common Questions,” Healthline.com, 08/14/24
Source: “Are Weight Loss Drugs Like Ozempic Safe While Trying to Get Pregnant?,” Healthline.com, 04/25/23
Source: “Are GLP-1 receptor agonist drugs safe to use in pregnancy?,” MedicalNewsToday.com, 12/16/23
Source: “Prenatal exposure to GLP-1 receptor agonists and other second-line antidiabetics may not pose greater risk to infants than insulin,” Harvard.edu, 12/11/23
Source: “First Large Study of GLP-1 Receptor Agonists During Pregnancy,” JAMANetwork.com, 01/02/24
Image by Vladimir Pustovit/Attribution 2.0 Generic