Poster Presentation Society of Obstetric Medicine of Australia and New Zealand ASM 2026

Pregnancy outcomes in women with type 2 diabetes mellitus conceiving on semaglutide therapy (#143)

Adam Morton 1 2 , Jessica Pulley 3
  1. Department of Medicine, University of Queensland, Brisbane, Queensland, Australia
  2. Obstetric Medicine and Endocrinology, Mater Health, Brisbane, Queensland, Australia
  3. Department of Medicine, Ipswich Hospital, Ipswich, Queensland, Australia

Background & Aim

Concerns have been raised that persons who conceive while receiving semaglutide therapy may be at risk of increased “rebound” weight gain and small-for-gestational-age (SGA) neonates.1,2 Pregnancy outcomes between women with T2DM managed with semaglutide therapy periconception (n=23) and T2DM women not receiving GLP1RA therapy (control group- n=161) were compared.

 

Method

Retrospective observational study of pregnancies at a tertiary obstetric hospital in Brisbane between 2021 and  2024

 

Results

There was no significant difference in maternal age or BMI. Semaglutide-treated women presented for specialist medical care earlier in pregnancy than controls (10.1 vs 13.4 weeks, p=.006).  Periconception HbA1c was 7.2% in semaglutide-treated group vs 7.7% in control group (p=.105). Periconception HbA1c was <6.5% in 55% of semaglutide-treated group vs 37% of control group (p=.7). Semaglutide-treated women gained more weight during pregnancy (17.6 vs 13.4kg, p=.018) although the increase in BMI did not reach significance (5.2 vs 4.9 kg/m2, p=.06). Mean birthweight was higher in the semaglutide-treated women than the control group (3441 vs 3123g, p=.044). SGA babies occurred in 0/23 semaglutide-treated women and 12/158 (7.5%) in control group (p=.17) LGA babies occurred in 8/23 semaglutide-treated women (34.7%) and 44/158 (27.8%) of control women (p=.49) Major congenital malformation (MCM) occurred in one semaglutide-treated woman while 20 MCMs (12.6%) occurred in the control group (p=.25). There were no fetal/neonatal deaths in the semaglutide-treated group and 15   fetal/neonatal deaths (9.4%) in the control group (p=.12).

 

Conclusion

Semaglutide therapy periconception was associated with greater maternal weight gain, but without adverse fetal outcomes.

  1. 1. Thapaliya K, Sweeting A, Black KI, et al. 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, 223:365-371.
  2. 2. Kolding L, Henriksen JN, Saedder EA, et al. Pregnancy Outcomes After Semaglutide Exposure. Basic Clin Pharmacol Toxicol 2025; 136: e70021.