{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:53:13Z","timestamp":1791161593516,"version":"4.1.0"},"reference-count":116,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>An increasing number of women of childbearing age worldwide are using glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101 RAs) and are advised to use effective contraception during treatment. Nevertheless, maternity services are encountering increasing numbers of women exposed to GLP\u20101 RAs shortly before conception or during pregnancy. The true extent of exposure is likely underestimated because routine enquiry is not universal. The effects of GLP\u20101 RA exposure on pregnancy remain poorly understood, and there is currently limited guidance on counselling women with inadvertent periconceptional exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Narrative review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population or Sample<\/jats:title>\n                    <jats:p>Original research articles, systematic reviews and meta\u2010analyses published in English from inception to 2026 were considered for inclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A non\u2010systematic literature search of PubMed, Google Scholar, MEDLINE and Embase was undertaken. Evidence relating to GLP\u20101 RA use from preconception through pregnancy and the postnatal period was reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Key findings relating to preclinical safety data, human pregnancy outcomes\u2014including congenital anomalies, hypertensive disorders of pregnancy, gestational diabetes, preterm birth, fetal growth and stillbirth; pharmacokinetic and drug washout considerations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>GLP\u20101 RAs improve weight and metabolic parameters and may improve fertility outcomes in selected populations, including women with obesity and polycystic metabolic ovarian syndrome (PMOS). Available human observational data have not demonstrated a clear increase in adverse pregnancy outcomes following periconceptional exposure. However, the evidence base is limited by small numbers, observational study designs, potential confounding and incomplete ascertainment of exposure and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Current observational data have not identified a clear safety signal associated with inadvertent periconceptional exposure to GLP\u20101 RAs. However, robust pregnancy safety data remain limited and are insufficient to exclude clinically important risks. Further prospective data and consistent reporting of pregnancy exposures are needed. In the meantime, women with inadvertent exposure should receive individualised counselling based on the available evidence rather than assuming that exposure is either established to be harmful or proven to be safe.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70339","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:45:29Z","timestamp":1791161129000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Glucagon\u2010Like Peptide\u20101 Receptor Agonists in Pregnancy: Periconception Exposure and Perinatal Outcomes"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9516-919X","authenticated-orcid":false,"given":"Katherine G. Y.","family":"Lau","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology St. Mary's Hospital, Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisha","family":"Chopra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology St. Mary's Hospital, Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1886-6358","authenticated-orcid":false,"given":"Edward","family":"Mullins","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction Imperial College London  London UK"},{"name":"The George Institute for Global Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rochan","family":"Agha\u2010Jaffar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology St. Mary's Hospital, Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tricia","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7806-5707","authenticated-orcid":false,"given":"Lynne","family":"Sykes","sequence":"additional","affiliation":[{"name":"Imperial College Parturition Research Group, Department of Metabolism, Digestion and Reproduction, Institute of Reproductive and Developmental Biology Imperial College London  London UK"},{"name":"Parasol Foundation Centre for Women's Health and Cancer Research St Mary's Hospital, Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4494-8162","authenticated-orcid":false,"given":"Christina K. 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