Jacqueline Maya, MD, Massachusetts General Hospital 
Published in JAMA, November 2025

Women are advised to be in their best possible health before getting pregnant to lower the risk of complications. Obesity medications have been a boon, helping people lose weight and better manage type 2 diabetes before conception. 

However, questions remain about how one very effective and popular class of drugs, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as liraglutide, semaglutide, and tirzepatide, affects maternal and infant health—especially considering people must discontinue the medications during pregnancy.

With the support of an American Diabetes Association® (ADA) Junior Faculty Development Award, pediatric endocrinologist Dr. Maya is working to fill this important gap in knowledge. “People describe these weight-loss medications as life-changing. They aren’t going away,” she noted. “We need to pay closer attention to these pregnancies to understand how to better treat women who take GLP-1 RAs and want to have a healthy baby.”

To achieve this goal, Dr. Maya and her team examined nearly 150,000 pregnancy records from the Mass General Brigham healthcare system and identified people who had taken GLP-1 RAs in the three years before conceiving and gone on to deliver single, full-term babies. They matched these patients to women who hadn’t used the medications but otherwise shared similar characteristics—such as pre-pregnancy body mass index (BMI), chronic conditions like diabetes and high blood pressure, and socioeconomic traits—and compared their pregnancy outcomes.

They found that women who stopped GLP-1 RAs before or early in pregnancy gained more weight and had higher risks of preterm birth, gestational diabetes (GDM), and high blood pressure than those who hadn’t taken the drugs. However, babies born to both groups showed no significant differences in size for gestational age, birth length, or cesarean delivery rates—a result Dr. Maya calls “reassuring.”

She attributes the higher pregnancy complication rates to a confluence of factors. Weight regain is common after stopping any weight-loss treatment, including GLP-1 RAs. This rebound effect may be compounded by weight gain, hormonal shifts, and other normal physiological changes during pregnancy.

Despite the added risks, taking a GLP-1 RA before pregnancy may still prove better than not losing weight at all. Further research could clarify when and how women should taper obesity medications before planning a pregnancy and identify ways to help them manage pregnancy weight gain to minimize complications.

As Dr. Maya states: “I feel very fortunate that I had funding from the ADA. It allowed me to collaborate with epidemiologists, biostatisticians, and other researchers, which will hopefully allow us to get as close to the truth as we can.”