A Retrospective Cohort Study of GLP-1 receptor agonist therapy in pregnant women with insulin resistance

Fionn Walsh; R. Murphy; C. Doyle

doi:10.5281/zenodo.22812610

Authors

Fionn Walsh Division of Diabetes and Endocrinology, Brahmaputra Institute for Advanced Metabolic Disease Author https://orcid.org/9659-3963-2856-8894
R. Murphy Department of Diabetes and Endocrinology, Colorado Institute for Advanced Diabetes and Endocrinology Author https://orcid.org/9673-7978-4293-437X
C. Doyle Department of Diabetes and Endocrinology, Clyde Research Center for Metabolic Disease Author https://orcid.org/7344-9272-8635-3488

DOI:

https://doi.org/10.5281/zenodo.22812610

Keywords:

GLP-1 receptor agonist, insulin resistance, pregnancy, gestational diabetes, retrospective cohort

Abstract

Graphical abstract

Background/Objective: GLP-1RA are widely prescribed to insulin-resistant women of reproductive age but are not recommended in pregnancy; we compared outcomes by discontinuation timing after conception [1,13].

Methods: Retrospective cohort of 248 pregnant women with insulin resistance prescribed a GLP-1RA before conception at three centers, 2018-2023, comparing early discontinuation (≤4 weeks, n=164) with continued exposure (>4 weeks, n=84) [16].

Results: Continued exposure showed higher third-trimester HbA1c (6.0% vs 5.7%), gestational diabetes (33.3% vs 28.7%), preeclampsia (14.3% vs 9.1%), and NICU admission (21.4% vs 15.2%); congenital anomaly rates were low and similar (3.6% vs 2.4%) [13,29].

Conclusions: Prompt GLP-1RA discontinuation was associated with more favorable outcomes, supporting guidance to discontinue GLP-1RA before conception and substitute insulin or metformin in pregnancy [11,24].

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