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Getting the latest healthcare news for you
Women who used semaglutide before or during pregnancy faced significantly higher risks for gestational diabetes, excessive weight gain, and cesarean delivery compared to nonusers. Notably, risks were similar whether women stopped the drug before conception or continued into pregnancy — suggesting post-discontinuation weight rebound, not direct fetal exposure, may be the key driver. With GLP-1 prescribing in pregnancy surging 30-fold since 2019, these findings are increasingly urgent for clinicians.
Women with overweight or obesity who used semaglutide before or during pregnancy had significantly worse pregnancy outcomes than those who never used the drug, according to a large retrospective cohort study published in Obstetrics & Gynecology. Researchers analyzed data from over 3,400 women across 30 U.S. healthcare systems, finding elevated risks for gestational diabetes, excessive fetal growth, and cesarean delivery in both pregnancy-exposed users and those who stopped the drug before conceiving.
Crucially, outcomes were nearly identical between women who stopped semaglutide before pregnancy and those who continued into it — pointing to post-discontinuation weight rebound as a likely driver rather than direct fetal exposure. Rapid weight regain after stopping GLP-1 drugs is well-documented, and excessive gestational weight gain is a known contributor to pregnancy complications. This context is especially important given that GLP-1 prescribing in the perinatal period has surged 30-fold between 2019 and 2024, with an estimated 20,000 pregnant individuals exposed in 2024 alone.
By the Numbers
Why it matters: With GLP-1 use expanding rapidly among reproductive-age women and approximately 40% of U.S. pregnancies unplanned, inadvertent exposure is increasingly common. These findings highlight the importance of counseling patients on contraception, weight management strategies around conception, and the potential risks associated with stopping GLP-1 medications without a structured plan.
