Emerging research from Flinders University indicates that many Australian women of reproductive age prescribed GLP-1 receptor agonists, increasingly popular for weight loss, may lack awareness of the potential risks associated with pregnancy and fetal development.
The study, featured in the Medical Journal of Australia, analyzed data from over 1.6 million women aged between 18 and 49 years who visited general practices between 2011 and 2022. It reported that out of 18,010 women beginning treatment with GLP-1 receptor agonists during this period, only 21% were utilizing effective contraception, raising significant concerns regarding unintended pregnancies.
Originally designed for managing type 2 diabetes, medications such as Ozempic have recently surged in popularity for their appetite-suppressing properties. Notably, the research revealed that a majority of prescriptions are now being issued to women without a diabetes diagnosis.
According to Associate Professor Luke Grzeskowiak, the lead author and a pharmacist at the College of Medicine and Public Health, over 6,000 women started treatment with GLP-1 receptor agonists in 2022, and more than 90% of those did not have diabetes. “While these medications can be highly effective, they carry risks, particularly when it comes to pregnancy,” he explained.
The study highlighted that 2.2% of women conceived within six months of initiating GLP-1 treatment, with higher pregnancy rates observed among younger women with diabetes, as well as women in their early thirties without diabetes. Interestingly, women suffering from polycystic ovary syndrome were found to be twice as likely to become pregnant, suggesting that the weight loss associated with these medications might inadvertently enhance fertility.
Data from a previous review conducted by the University of Amsterdam indicated a potential link between GLP-1 exposure during pregnancy and adverse fetal outcomes, including reduced growth and skeletal abnormalities. Although the available human data remains limited, these findings prompt concerns regarding the safety of these medications during pregnancy.
In light of these results, Professor Grzeskowiak emphasized that existing clinical practices in Australia do not consistently follow safety advice. The UK guidelines recommend that women on GLP-1 receptor agonists should avoid pregnancy and employ effective contraception, yet this guidance may not be adequately communicated in the Australian healthcare system. “Reproductive health considerations must be included in every discussion when prescribing these drugs to women of childbearing age,” he stated.
To promote safe usage, the researchers advocate for more robust guidelines concerning GLP-1 prescriptions. “Consulting with a healthcare professional about the risks and benefits of GLP-1 medications is essential before starting any treatment,” Professor Grzeskowiak added.
The findings underscore the need for further investigations into the implications of GLP-1 receptor agonists on pregnancy and fetal development to ensure the health and safety of both women and their unborn children.
Reference: Thapaliya K, Sweeting A, Kirsten BI, Poprzeczny A, Mazza D, Grzeskowiak LE. Incidence of GLP-1 receptor agonist use by women of reproductive age attending general practices in Australia, 2011–2022: a retrospective open cohort study. Med J Aust. 2025. doi: 10.5694/mja2.70026
