An analysis of more than one million primary care records by an Australian research team shows that many women of childbearing age who start using GLP-1 receptor agonist weight-loss drugs do not use effective contraception, which may pose pregnancy risks.
Studies have pointed out that the widespread use of popular weight loss drugs such as Ozempic may bring hidden risks to women's pregnancy and fetal development. A team of researchers led by Flinders University has found that most Australian women of childbearing age who are prescribed GLP-1 receptor agonists, which are increasingly used as weight loss tools, do not use effective contraception when taking them.
The findings were published in the Medical Journal of Australia. The research team analyzed the general medical visit records of more than 1.6 million women aged 18 to 49 between 2011 and 2022. During the study period, 18,010 people initiated GLP-1 receptor agonist treatment, and only 21% reported using contraception.
GLP-1 receptor agonists were originally used to treat type 2 diabetes but are now widely used to control appetite and weight. The study found that currently most prescriptions have been given to non-diabetic female patients.
Lead author Luke Grzeskowiak, associate professor of pharmacy, said that more than 6,000 women will start GLP-1 treatment in 2022 alone, and more than 90% of them will not have a diagnosis of diabetes. "We are seeing more and more women of childbearing age using these drugs, but very few patients are being advised to use contraception regularly while taking the drugs," he said. Grzeskoviak, who works at Flinders University School of Medicine and Public Health, is an expert in the rational use of drugs during pregnancy and lactation.
“These drugs are very useful, but they are by no means completely risk-free – especially during pregnancy.”
The study also found that 2.2% of women became pregnant within six months of taking the drug. Pregnancy rates are highest among younger diabetic women and non-diabetic women in their early thirties. At the same time, women with PCOS are twice as likely to become pregnant, suggesting that weight loss may significantly improve fertility, even if some pregnancies are unplanned.
Of concern, women who used birth control at the time the drug was prescribed had a significantly lower risk of pregnancy.
A previous review of animal experiments by the University of Amsterdam showed that exposure to GLP-1 receptor agonists during pregnancy can lead to fetal growth restriction and abnormal bone development, although data in humans are limited and still worrying. The UK recommends that all women taking GLP-1 receptor agonists avoid pregnancy and use effective contraception, but this advice is not generally followed in Australian clinical practice.
"We need to ensure that reproductive health issues are discussed every time this medication is prescribed to women of childbearing age," Grzekoviak stressed. "In addition, clearer clinical recommendations and guidelines for doctors who prescribe this medication are also critical to ensure safe and effective use."
"Our advice is that before considering taking a GLP-1 drug, be sure to discuss the pros and cons with your doctor and only use medications prescribed by your doctor."
The research team also calls for further research to assess the effects of these drugs on pregnancy and the fetus.
Compiled from /ScitechDaily