GLP-1 discontinuation associated with more weight gain and pregnancy complications

In a study led by researchers at Mass General Brigham, pregnant individuals who stopped taking popular weight loss GLP-1 medications before or early in their pregnancy tended to gain more weight and have higher risks of diabetes and hypertensive disorders during pregnancy, and experienced preterm delivery more so than people who had never taken GLP-1 drugs. The findings are published in JAMA.

"The use of glucagon-like peptide-1 receptor agonists-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 Jacqueline Maya, MD, a pediatric endocrinologist at Mass General Brigham for Children. "We sought to assess how such discontinuation affects weight gain and outcomes during pregnancy."

For the study, the team analyzed electronic health records for 1,792 pregnancies delivered within the Mass General Brigham healthcare system between 2016–2025, primarily among women with obesity. Each woman with a GLP-1RA 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-1RAs.

Individuals who stopped GLP-1RAs 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-1RA group also had a 32% higher risk of excess weight gain (gaining more than recommended), a 30% higher risk of diabetes during pregnancy, a 29% higher risk of hypertensive disorders during pregnancy, and a 34% higher risk of preterm delivery. There were no differences in risk of high or low birth weight, birth length, or Cesarean delivery.

"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 Camille E. Powe, MD, a Mass General Brigham endocrinologist and co-director of the Diabetes in Pregnancy Program at Massachusetts General Hospital. "We need to do more research to find ways to help manage weight gain and reduce risks during pregnancy when stopping GLP-1 medications."