#2-76E. Weight Regain Risk: Pregnancy Outcomes After GLP-1RA Discontinuation (JAMA, 2025)

As Glucagon-like Peptide-1 Receptor Agonists (GLP-1RAs) are increasingly used for obesity and type 2 diabetes, how should clinicians counsel reproductive-aged women who must discontinue these medications when planning pregnancy? This retrospective cohort study examined 1,792 propensity score-matched singleton pregnancies, comparing outcomes in individuals who discontinued GLP-1RAs prior to or early in pregnancy versus unexposed controls, specifically assessing effects on gestational weight gain (GWG) and adverse outcomes. The key finding is that GLP-1RA discontinuation was associated with a significantly greater mean GWG of 3.3 kg and a higher risk of adverse outcomes, including preterm delivery, gestational diabetes, and hypertensive disorders of pregnancy. This association suggests that weight regain after stopping GLP-1RAs may contribute to poor obstetric outcomes. However, physicians must remember this is a retrospective observational study, meaning residual confounding remains a key limitation, despite robust matching. This research is crucial for clinicians as it highlights the need for enhanced prepregnancy counseling and vigilant monitoring of GWG in this specific high-risk population to mitigate potential complications.

Citation: Maya J, Pant D, Fu Y, et al. Gestational Weight Gain and Pregnancy Outcomes After GLP-1 Receptor Agonist Discontinuation. JAMA. 2025. DOI: 10.1001/jama.2025.20951

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