ArticleFrontiers in pharmacology2026
Pregnancy and perinatal outcomes following exposure to GLP-1 and dual GLP-1/GIP receptor agonists: a time-window-stratified systematic review and meta-analysis.
Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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2 authors.
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Abstract
Background: To evaluate maternal, fetal, and neonatal outcomes after preconception or gestational exposure to glucagon-like peptide-1 receptor agonists and dual glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide receptor agonists, and to assess the reproducibility of reported safety signals. Methods: Six databases plus a drug-level safety search were searched through 16 July 2026. Exposure was classified into four clinically defined time windows. Independent studies or data sources were the analytic unit; one primary comparator was selected per study, and odds ratios and risk ratios were synthesized separately. Random-effects meta-analysis, timing-stratified and dominant-study sensitivity analyses, Newcastle-Ottawa Scale assessment, and GRADE certainty assessment were used. Results: Fourteen comparative data sources were included; 13 were quantitatively eligible and eight contributed to at least one pooled estimate. In the timing-specific analysis of major congenital malformations, four studies with verified periconceptional/first-trimester exposure yielded an odds ratio of 0.99 (95% confidence interval 0.77-1.27). A secondary pregnancy-period analysis that added one unadjusted, trimester-unspecified cohort yielded 1.00 (0.94-1.06); that cohort contributed 93.5% of the weight. Pooled preterm birth, small-for-gestational-age birth, and stillbirth analyses showed no statistically significant differences. Preeclampsia and other sparse outcomes were not pooled. Certainty was very low for all key outcomes. Conclusion: Current evidence does not demonstrate a clear or consistent increase in major congenital malformation risk, but very low certainty, imprecision, residual confounding, heterogeneous comparators, sparse agent-specific data, and uncertain exposure timing preclude conclusions of safety. Reported preeclampsia and renal or urinary signals have not been independently replicated.
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