Thinking about pregnancy while worrying about your weight can feel stressful. You’re not alone—about 6 in 10 women in the U.S. are overweight or obese. Talking about weight can be difficult, but it’s an important part of planning for a healthy pregnancy.
This blog will explain how weight can affect pregnancy, what GLP-1 drugs are, and what we know so far about their use before and during pregnancy.
Why is pre-pregnancy weight management so important?
Being overweight or obese increases the chance of many pregnancy-related problems, including:
- Failure
- Birth defects
- Preterm birth (before 37 weeks)
- Gestational diabetes
- High blood pressure during pregnancy
- Necrobirth
- Delivery by caesarean section
- Thromboembolic events (blood clots)
You can read more about obesity and pregnancy in our newsletter here:
The good news is even a small amount of weight loss—as little as 5-7% of your body weight—before pregnancy can improve health and pregnancy outcomes. It’s best to start before you get pregnant. Some people do this through healthy eating and exercise, while others may need surgery or medication.
What are GLP-1 drugs?
GLP-1s are drugs that act like a natural hormone in your body. They help control blood sugar, slow down digestion and make you feel fuller for longer. This can lead to weight loss. Most GLP-1s are given as shots. The best known are liraglutide (Victoza®) and semaglutide (Ozempic®, Wegovy®, Rybelsus®). These are also the ones that have been studied the most in pregnancy so far.
Can I use GLP-1 while trying to get pregnant?
Current product labels recommend discontinuing GLP-1 drugs at least 2 months before pregnancy. The time it takes for the body to process medicines is not the same for everyone. In healthy non-pregnant women, it can take up to 6 weeks, on average, for most of the GLP-1 to leave the body.
Stopping the medication can sometimes cause weight gain, which can feel frustrating. Because of this, some people choose to continue until they find out they are pregnant. It is best to talk to your healthcare provider about the risks and benefits for you.
What do we know about GLP-1 in pregnancy?
Here’s what the research tells us so far:
- Studies involving more than 1,000 women exposed to GLP-1 during the first trimester did not show an increased chance of birth defects.
- A study of 168 pregnancies with first-trimester exposure to GLP-1 showed no increased odds of miscarriage, preterm birth, stillbirth, or SGA (small for gestational age infants whose birth weight is less than 10u percentile for gestational age).
It is important to remember that every pregnancy has a basic risk:
- Of all babies born each year, about 3 in 100 (3%) will have a birth defect
- 15 to 20 out of 100 (15-20%) pregnancies end in miscarriage
These usually occur in the first trimester — regardless of whether or not medication is used.
Why are GLP-1s not recommended during pregnancy?
At this time, continuation of GLP-1s after pregnancy is confirmed is not recommended for two main reasons:
- Losing weight during pregnancy is not recommended. Losing weight during pregnancy can increase the chances of having an SGA baby, which can lead to complications such as:
- Low oxygen levels
- Low Apgar scores (scoring system on newborns to determine their well-being)
- Meconium aspiration (breathing during first bowel movement)
- Hypoglycemia (low blood sugar)
- Difficulty maintaining body temperature
- Polycythemia (too many red blood cells)
- We lack research on GLP-1s in the second and third trimesters. Without research studies on use in the second and third trimesters, we don’t know if GLP-1 use could increase the chances of other pregnancy-related problems.
Finding the path that’s right for you
Your journey is unique and there is no simple answer. That’s why it’s so important to talk to your healthcare provider about how best to approach weight management before pregnancy. As Dr. Sarah Obican so masterfully said in a previous Baby Blog post:
“Each of us is beautifully unique” — and weight loss and pregnancy journeys are also beautifully individual.
Final Thoughts
Whether you’re already on a weight loss journey or just starting to think about pregnancy, you deserve support and reliable information. We are here to help you every step of the way.
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