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GLP-1 Discontinuation During Pregnancy Linked to Increased Risks, Study Finds
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Stopping medications like Ozempic and Wegovy before or during pregnancy may lead to greater gestational weight gain and a higher chance of complications like preterm delivery and gestational diabetes.
A new study published today, November 24, 2025, in JAMA, reveals a concerning link between discontinuing glucagon-like peptide-1 receptor agonists (GLP-1 RAs) – a class of drugs widely used for weight loss and type 2 diabetes management – and adverse pregnancy outcomes. Researchers found that women who stopped taking these medications before or early in pregnancy experienced greater gestational weight gain and an increased risk of several complications, including preterm delivery, gestational diabetes, and hypertensive disorders of pregnancy.
The Growing Use of GLP-1 RAs and the Pregnancy Dilemma
GLP-1 RAs have become increasingly popular among women of reproductive age seeking to manage their weight and glucose levels. These medications work by improving glycemic control, promoting weight loss, and offering cardiovascular benefits. However, due to animal studies demonstrating potential fetal harm – including structural abnormalities, intrauterine growth restriction, and embryofetal mortality – these therapies are not recommended during pregnancy. Consequently, most patients discontinue GLP-1 RAs before conception or upon learning thay are pregnant.
Despite this widespread practice, data on the consequences of this discontinuation, particularly regarding outcomes beyond birth defects, have been limited. Researchers recognized the need to understand if stopping these medications before or during pregnancy could impact maternal and infant health.
Study Findings: Increased Weight Gain and Pregnancy Complications
The study, conducted by researchers at Mass general Brigham, involved a retrospective cohort of 1,589 pregnant individuals who had previously used GLP-1 RAs. The researchers compared outcomes between those who continued GLP-1 RA use during the first trimester (n=188) and those who discontinued the medication before or during the first trimester (n=1,401).
the results showed a notable difference in weight gain between the two groups. Exposed pregnancies experienced an average weight gain of 13.7 kg (SD, 9.2 kg), compared to 10.5 kg (SD,8.0 kg) in the unexposed group – a difference of 3.3 kg (95% CI, 2.3-4.2; P < .001).
Furthermore, the study found:
- A higher rate of excess gestational weight gain in the exposed group (65% vs. 49%; risk ratio [RR] 1.32; 95% CI, 1.19-1.47).
- A higher mean birth weight percentile in the exposed group (58.4% vs. 54.8%; difference, 3.6%; 95% CI,0.2%-6.9%).
- An increased risk of preterm delivery (17% vs. 13%; RR, 1.34; 95% CI, 1.06-1.69).
- An increased risk of gestational diabetes (20% vs. 15%; RR, 1.30; 95% CI, 1.01-1.68).
- An increased risk of hypertensive disorders of pregnancy (46% vs. 36%; RR, 1.29; 95% CI, 1.12-1.49).
Notably, the study did not find significant differences in birth length, large or small for gestational age outcomes, or cesarean delivery rates.
Limitations and Future Research
The researchers acknowledged limitations inherent to observational studies, including the potential for residual confounding.They also noted that the study population – drawn from Mass General Brigham – may not be fully representative of the broader population, being older, less likely to have a BMI of 25 or higher, and less diverse in terms of race and insurance coverage.
despite these limitations, the findings underscore the need for further examination. “More data are needed on the implications of GLP-1 RA discontinuation-associated gestational weight gain for long-term weight retention in mothers and programming effects in offspring,” the authors wrote. They emphasized the importance of developing clinical approaches to mitigate excess gestational weight gain in individuals with obesity and diabetes who were previously using GLP-1 RAs. .
