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Women exposed to glucagon-like peptide-1 (GLP-1) receptor agonists around conception did not have a “clearly detectable increase” in adverse outcomes for themselves or their babies, according to the results of a systematic review and meta-analysis.
Publishing their findings in Med on 29 September 2026, researchers conducted a review of ten studies which looked at pregnancy outcomes in women exposed to GLP-1 receptor agonists before conception or in the very early stages of pregnancy, before the pregnancy was recognised.
In total, the researchers analysed data from 2,118,215 pregnancies.
Of these pregnancies, 8,325 were in women exposed to a GLP-1 receptor agonist around the time of conception and within six months before a positive pregnancy test, the researchers found.
They also observed that compared with pregnancies without exposure, no clearly detectable increase in the risk of miscarriage, stillbirth, congenital anomalies, preterm birth, gestational diabetes, high blood pressure, excessive maternal weight gain and other adverse outcomes were found.
The authors of the review noted that as many pregnancies are unplanned, “accidental exposure” to GLP-1s may be likely.
Lead author Asma Khalil, professor of obstetrics and maternal foetal medicine at City St George’s, University of London, said: “The message for patients is that if you discover you were taking one of these medicines before you knew you were pregnant, you should not panic. Speak to your healthcare team, who can provide personalised advice and support.”
However, the authors highlighted that the findings should not be read as proof that the medicines are safe in pregnancy, and further research is needed.
Guidance from the Medicines and Healthcare products Regulatory Agency, published in February 2026, underscores that GLP-1 medicines should not be taken during pregnancy or just before trying to get pregnant “because there is not enough safety data to know whether taking a GLP-1 medicine can cause harm to the baby”.
It also advises stopping semaglutide at least two months — and tirzepatide at least one month — before pregnancy, which is based on “some animal studies” that found GLP-1s were harmful to the unborn foetus.
Ashifa Trivedi, clinical lead pharmacist in medicines and neonates at Evelina London Children’s Hospital, told The Pharmaceutical Journal that the Med study findings are “reassuring” as inadvertent exposure in early pregnancy is likely to become more common as more women of reproductive age use GLP-1 receptor agonists.
She added: “However, it is important that these findings are interpreted carefully. Finding no detectable increase in adverse pregnancy outcomes following exposure around conception is not the same as demonstrating that these medicines are safe to use during pregnancy.
“The evidence is based on observational studies and therefore there remain important gaps in our understanding, including the effects of individual GLP-1 receptor agonists and exposure at different stages of pregnancy.
“They do not currently change recommendations that GLP-1 receptor agonists should not be used during pregnancy and should be stopped before a planned pregnancy.”
