Accidental GLP-1 Drug Exposure Around Conception: Scoping Review Finds No Increased Risk of Major Birth Defects
A scoping review of 13 studies found that accidental periconceptional exposure to GLP-1 receptor agonists was not associated with increased risk of major congenital malformations or pregnancy loss, though only minor complications were reported.
Quick Facts
What This Study Found
From 881 screened articles, 13 met inclusion criteria: 10 case reports and 3 cohort studies examining pregnancy outcomes after periconceptional GLP-1 receptor agonist exposure.
Key findings across all included studies:
- No increased risk of major congenital malformations in any study
- No pregnancy losses or elective terminations reported in any study
- Minor complications reported in case reports included: emergency cesarean delivery, preeclampsia, macrosomia (large baby), shoulder dystocia, and transient neonatal hypoglycemia
- These minor complications are common in pregnancies complicated by pre-existing diabetes and obesity
Key Numbers
How They Did This
The scoping review followed Joanna Briggs Institute methodology. Databases searched included MEDLINE, Embase, Scopus, open-access clinical trial registries, ProQuest Dissertations & Theses Global, and medRxiv, covering January 2005 to March 2025. All evidence levels and report types were included. Articles were screened in duplicate at abstract and full-text levels by two independent reviewers, with disagreements resolved through consensus. Data from 13 eligible articles were charted and summarized narratively.
Why This Research Matters
This is one of the most urgent questions in reproductive health right now. The 'Ozempic baby' phenomenon — unexpected pregnancies in women on GLP-1 drugs whose fertility was restored by weight loss — has generated widespread public concern. Women who discover they're pregnant while on these medications need evidence-based guidance about whether to be worried. This review provides early reassurance that accidental exposure does not appear to cause major birth defects, though the evidence remains limited.
The Bigger Picture
GLP-1 receptor agonists are among the most prescribed medications globally, and their use is expanding rapidly beyond diabetes into obesity management. As reproductive-age women increasingly take these drugs, accidental periconceptional exposure will become more common. Establishing a safety profile for early pregnancy exposure is critical for clinical guidelines, patient counseling, and informed consent. This review represents the first systematic synthesis of available evidence on this increasingly important question.
What This Study Doesn't Tell Us
The evidence base is extremely limited — only 13 studies, predominantly case reports (10 of 13), which represent the lowest level of clinical evidence. The 3 cohort studies are not sufficient for definitive conclusions. The total number of exposed pregnancies across all studies is very small. Publication bias may favor reporting of adverse outcomes. The review cannot distinguish between effects of the drug and effects of the underlying conditions (diabetes, obesity) that prompted its use. Long-term developmental outcomes of exposed children are not available. Different GLP-1 drugs may carry different risks.
Questions This Raises
- ?Should women of reproductive age be counseled about contraception when starting GLP-1 receptor agonists, given that weight loss can restore ovulation?
- ?Are there differences in pregnancy safety between different GLP-1 drugs (semaglutide, liraglutide, tirzepatide)?
- ?What are the long-term developmental outcomes for children exposed to GLP-1 drugs during the periconceptional period?
Trust & Context
- Key Stat:
- 0 increased major malformation risk Across all 13 included studies — 10 case reports and 3 cohort studies — no study found an increased risk of major congenital malformations from periconceptional GLP-1 receptor agonist exposure.
- Evidence Grade:
- This is a scoping review with rigorous methodology (JBI framework, dual screening, comprehensive database search), but the underlying evidence is weak — predominantly case reports with only 3 cohort studies. The total number of exposed pregnancies is small. The review accurately characterizes the current evidence landscape but cannot provide definitive safety conclusions.
- Study Age:
- Published in 2026 with a search through March 2025, this is the most current synthesis of evidence on GLP-1 drugs and pregnancy outcomes. This topic is evolving rapidly as more exposure data accumulates.
- Original Title:
- Outcomes of Maternal Periconceptional Exposure to Glucagon-Like Peptide-1 Receptor Agonists: A Scoping Review of Evidence and Reporting Trends.
- Published In:
- Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 48(1), 103191 (2026)
- Authors:
- Lee, In Ok, Ghiasi, Maryam, Wong, Karen, Walker, Mark
- Database ID:
- RPEP-15499
Evidence Hierarchy
Frequently Asked Questions
I got pregnant while taking a GLP-1 drug — should I be worried about birth defects?
Based on the limited evidence available (13 studies), accidental exposure to GLP-1 drugs around the time of conception has not been associated with an increased risk of major birth defects or pregnancy loss. However, you should stop the medication and inform your doctor immediately. Your healthcare team can monitor your pregnancy closely and provide personalized guidance. More research is needed to fully understand the safety profile.
Why are more women getting pregnant while on GLP-1 drugs?
GLP-1 drugs cause significant weight loss, which can restore ovulation in women whose fertility was reduced by obesity. Some women on hormonal birth control may also experience reduced contraceptive effectiveness due to the GI effects of these drugs. This combination has led to an increase in unplanned pregnancies among GLP-1 users, making this safety question increasingly important.
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Cite This Study
https://rethinkpeptides.com/research/RPEP-15499APA
Lee, In Ok; Ghiasi, Maryam; Wong, Karen; Walker, Mark. (2026). Outcomes of Maternal Periconceptional Exposure to Glucagon-Like Peptide-1 Receptor Agonists: A Scoping Review of Evidence and Reporting Trends.. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 48(1), 103191. https://doi.org/10.1016/j.jogc.2025.103191
MLA
Lee, In Ok, et al. "Outcomes of Maternal Periconceptional Exposure to Glucagon-Like Peptide-1 Receptor Agonists: A Scoping Review of Evidence and Reporting Trends.." Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2026. https://doi.org/10.1016/j.jogc.2025.103191
RethinkPeptides
RethinkPeptides Research Database. "Outcomes of Maternal Periconceptional Exposure to Glucagon-L..." RPEP-15499. Retrieved from https://rethinkpeptides.com/research/lee-2026-outcomes-of-maternal-periconceptional
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.