Price Sarah A L, Nankervis Alison
Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Grattan St, Parkville, VIC, 3050, Australia.
Department of Obstetric Medicine, Royal Women's Hospital, Flemington Rd, Parkville, VIC, Australia.
Arch Gynecol Obstet. 2025 May;311(5):1241-1247. doi: 10.1007/s00404-024-07849-9. Epub 2025 Jan 7.
Metabolic disease, including obesity and type 2 diabetes, are amongst the most significant health issues facing women of reproductive age. To date, no antenatal weight management tools have reduced the risk of adverse health outcomes for women with obesity and their offspring, resulting in a shift in focus to the pre-conception period. Although not yet recognised in most international weight management guidelines, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are being increasingly used for weight management prior to conception.
A literature search of PubMed, Medline, and Embase databases identified relevant articles describing the use of GLP-1 RAs prior to and during pregnancy. Papers were selected based on relevance and originality, with clinical trials, large observational studies and meta-analyses being preferentially included.
This narrative review summarises the mechanism of action of GLP-1 RAs and the clinical effects observed in non-pregnant adults. It synthesises the available data from human and animal studies regarding the safety and efficacy of GLP-1 RAs prior to pregnancy, and the consequences of inadvertent drug exposure in early pregnancy. In considering the need to balance the risks of metabolic disease with the risks posed by inadvertent drug exposure, it highlights the areas where further research is needed to guide clinical decision-making.
GLP-1 RAs may have a role in facilitating weight loss and improving the metabolic health of women prior to pregnancy. However, there is currently insufficient evidence to demonstrate that the use of this class of drugs prior to pregnancy improves pregnancy outcomes.
代谢疾病，包括肥胖症和2型糖尿病，是育龄女性面临的最重大健康问题之一。迄今为止，尚无产前体重管理工具能够降低肥胖女性及其后代出现不良健康结局的风险，这导致关注点转向孕前阶段。尽管在大多数国际体重管理指南中尚未得到认可，但胰高血糖素样肽-1受体激动剂（GLP-1 RAs）在孕前体重管理中的应用越来越广泛。
通过对PubMed、Medline和Embase数据库进行文献检索，确定了描述GLP-1 RAs在孕前及孕期使用情况的相关文章。根据相关性和原创性筛选论文，优先纳入临床试验、大型观察性研究和荟萃分析。
本叙述性综述总结了GLP-1 RAs的作用机制以及在非孕成年人中观察到的临床效果。它综合了来自人体和动物研究的现有数据，涉及GLP-1 RAs在孕前的安全性和有效性，以及孕早期意外药物暴露的后果。在考虑平衡代谢疾病风险与意外药物暴露风险的必要性时，强调了需要进一步研究以指导临床决策的领域。
GLP-1 RAs可能在促进孕前体重减轻和改善女性代谢健康方面发挥作用。然而，目前尚无足够证据表明孕前使用这类药物能改善妊娠结局。
