Human pregnancy outcomes after early glucagon-like peptide-1 receptor agonist exposure: A scoping review

Table 1 Case reports of human glucagon-like peptide-1 receptor agonist exposure before or during pregnancy

Ref.	Country	GLP-1RA/dose	Exposure window/cessation timing	Maternal background/metabolic profile	Delivery/birth weight	Maternal outcome	Fetal/neonatal outcome	Follow-up	Interpretation
Williams et al[4], 2009	United States	Exenatide, dose NR	7 months preconception to 14 GW	35 years; T2D, HTN, obesity, proliferative retinopathy, microalbuminuria; HbA1c 10.4%	LUCS, 38 weeks; 2835 g	Preeclampsia, intra-amniotic infection, postpartum uterine infection	Low Apgar, mild encephalopathy, neonatal sepsis	3 months, uneventful	High-risk diabetes background; adverse neonatal outcome not clearly attributable to exenatide
Greco[5], 2015	Italy	Liraglutide 1.8 mg/day	2 years preconception to 12 GW	37 years; T2D for 5 years, obesity, PCOS, infertility; BMI: 32.2 kg/m2	LUCS, 37 weeks; 3790 g	Uneventful	Normal Apgar score; transient neonatal hypoglycemia	NR	Reassuring early liraglutide exposure; neonatal hypoglycemia likely diabetes-related
Ivanišević et al[6], 2018	Croatia	Liraglutide 1.8 mg/day	Preconception to throughout pregnancy and lactation	28 years; thyroidectomy for diffuse goiter/thyroid disease; uncontrolled T2D	LUCS, 39 weeks; 4220 g	Uneventful	Apgar 10/10; macrosomia	2 years, uneventful	Unique prolonged exposure/Lactation case; macrosomia likely related to diabetes
Livadas et al[7], 2020	Greece	Liraglutide 1.8 mg/day	14 weeks preconception to 6-7 GW	29 years; obesity with HAIR-AN syndrome, hirsutism, insulin resistance, acanthosis nigricans, severe PCOS	NR	Uneventful	Healthy baby	Uneventful	Reassuring inadvertent early exposure in severe PCOS/insulin-resistance phenotype
Burlina et al[8], 2023	Italy	Dulaglutide 1.5 mg/week	6 weeks preconception to 15 GW	38 years; T2D for 11 years, obesity	LUCS, 37 weeks; 2860 g	Gestational hypertension; 15 kg weight gain	Cavum septum pellucidum at 20 weeks, resolved; neonatal jaundice	NR	No persistent structural anomaly; maternal metabolic risk remains major confounder
Alghamdi et al[9], 2023	Saudi Arabia	Dulaglutide 1.5 mg/week	Preconception to 13 GW	39 years; T2D for 19 years, obesity	LUCS, 38 weeks; 3100 g	Uneventful	Mild bilateral pyelectasis; Down syndrome excluded	NR; unplanned pregnancy	Mild urinary finding; no clear teratogenic pattern
Skov et al[10], 2023	Denmark	Semaglutide 1 mg/week	7 months preconception to 4 GW	31 years; PCOS, uncomplicated myxedema	Vaginal delivery, 41 weeks + 5 days; 5230 g	35 kg gestational weight gain	Macrosomia, shoulder dystocia, neonatal hypoglycemia	6 months	Reassuring for malformation; macrosomia, shoulder dystocia, and neonatal hypoglycemia occurred in the setting of marked gestational weight gain and maternal metabolic risk
Wajtryt and Dedecjus[11], 2023	Poland	Semaglutide, dose NR	5 months preconception to 7 GW	43 years; T2D; G5P4	LUCS at term; 2750 g	Uneventful	None	NR	Reassuring but limited by sparse details
Patel and Healy[12], 2024	United States	Dulaglutide 0.75 mg/week	Preconception to 15 GW	41 years; T2D, PCOS, obesity	LUCS, 36 weeks; birth weight NR	Preeclampsia, preterm delivery	Polyhydramnios at 26 weeks, corrected by 32 weeks	NR	Maternal and fetal findings consistent with high-risk metabolic pregnancy
Molteni et al[13], 2024	Italy	Dulaglutide 1.5 mg/week	3 months preconception to 34 GW; continued during pregnancy	42 years; G6P5; T2D for 11 years; obesity, dyslipidemia	LUCS, 38 weeks, breech; 3790 g	5 kg weight gain; gestational hypertension	Polyhydramnios; fetal growth normal	NR	Important prolonged dulaglutide exposure; no malformation, but maternal HTN/polyhydramnios occurred
Okeke et al[14], 2024	United States	Semaglutide 2 mg, single self-administered dose	Before pregnancy recognition; pregnancy detected at 6-7 GW	34 years; G5P4; generalized anxiety, borderline personality, off-label weight loss, one previous preterm birth, three previous abortions	NR	NR	Hyperemesis gravidarum reported	NR	Limited interpretability; single-dose exposure and major psychiatric/obstetric background
Zhu et al[15], 2024	China	Semaglutide, dose NR	Before pregnancy to 6 GW	34 years; obesity	LUCS, 37 weeks; birth weight NR	NR	Micropenis, mild foot deformity	6 months, normal growth	Isolated anomaly report; no causal inference possible
Abushanab et al[16], 2025	Qatar	Liraglutide 3 mg/day	8 months preconception to 7 GW	29 years; G9P6; obesity, BMI 36 kg/m2; two previous preterm births, two abortions, four live births	LUCS, 37 weeks; 2330 g	Maternal weight gain 51 kg, from 80 kg to 131 kg	Low birth weight; Apgar 9/10	2 years, normal growth and neurodevelopment	Reassuring developmental follow-up; maternal weight rebound notable
Burlina et al[17], 2026	Italy	Dulaglutide, dose NR	Preconception to 23 GW	44 years; uncontrolled T2D	Vaginal delivery, birth weight 3025 g	Maternal weight gain 9 kg	No obstetric complications or congenital anomalies reported	NR	Prolonged exposure; reassuring but no follow-up
Huang et al[18], 2025	United States	Dulaglutide, dose NR	First-trimester exposure; exact GW NR	35 years; T2D, HTN, hyperlipidemia	NR	Hospitalized for septic arthritis of left shoulder with euglycemic DKA	Elective termination	NR	Termination and severe maternal illness confound fetal inference
Ozdemir[19], 2025	Greece	Liraglutide	Preconception to 3.5 GW	20 years; obesity	LUCS, 34 weeks; 2700 g	Developed GDM	NICU for 1 week	6 months, normal development	Early exposure; prematurity/GDM not clearly drug-related
Jin et al[20], 2026	China	Semaglutide 0.5 mg/week, off-label obesity use	6 months preconception to 7 GW	37 years; overweight, BMI: 27.73 kg/m2; chronic simple lichen planus; hypothyroidism	Vaginal delivery, 39.6 weeks; 3200 g	22 kg gestational weight gain; no GDM; no HTN or preeclampsia	Apgar 8/10 at 1 min, 10/10 at 5 min; fetal growth, NT and Doppler normal; healthy baby	3 months, uneventful	Reassuring early semaglutide exposure; GDM/weight gain remain important

Detailed Joanna Briggs Institute domain-level appraisal of case reports is provided in Supplementary Table 2. BMI: Body mass index; DKA: Diabetic ketoacidosis; G: Gravida; GDM: Gestational diabetes mellitus; GLP-1RA: Glucagon-like peptide-1 receptor agonist; GW: Gestational week; HAIR-AN: Hirsutism-insulin resistance-acanthosis nigricans; HbA1c: Glycated hemoglobin; HTN: Hypertension; LUCS: Lower uterine cesarean section; NICU: Neonatal intensive care unit; NR: Not reported/not retrievable; NT: Nuchal translucency; P: Para; PCOS: Polycystic ovary syndrome; T2D: Type 2 diabetes.