Researchers at Marshall University contributed to an international effort that released the first comprehensive clinical recommendations for the use of incretin-based medications, such as GLP-1 drugs, before, during, and after pregnancy, according to an Aug. 3 announcement. The new guidelines were published in Obesity Reviews by a team of experts from Europe, North America, and the Middle East.
The review systematically evaluated available evidence on incretin-based medications across the reproductive lifespan and established practical guidance for clinicians caring for women of reproductive age. Dr. Shahrad Taheri, professor and vice dean for adiposity-based chronic diseases at the Marshall University Joan C. Edwards School of Medicine, was the only U.S.-based contributor among authors from 23 institutions involved in this multidisciplinary collaboration.
The publication identifies critical knowledge gaps while offering recommendations on contraception, preconception care, pregnancy management, breastfeeding considerations, and postpartum health. The review analyzed 34 studies—including randomized clinical trials and observational research—to address questions related to fertility outcomes and maternal-child health.
While current evidence did not identify an increased risk of major congenital anomalies following inadvertent early pregnancy exposure to these medications, substantial gaps remain regarding long-term outcomes for mothers and children. Researchers found that incretin-based medications may improve fertility-related outcomes in women with polycystic ovary syndrome (PCOS), recently renamed polyendocrine metabolic ovarian syndrome (PMOS), as well as obesity prior to pregnancy; however, they say there is insufficient evidence to support their use during pregnancy or breastfeeding.
“This work represents an important step toward improving reproductive care for women living with obesity,” Taheri said. “As the use of these medications continues to grow, this guidance provides a foundation for clinicians and identifies important opportunities for future research. We look forward to advancing that work and supporting the health of women in West Virginia and beyond.”
The authors conclude that nearly half of clinically important questions about incretin-based medication use in reproductive health remain unanswered, highlighting a need for further prospective studies and long-term follow-up.
