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Lookup NU author(s): Professor Nicola HeslehurstORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 The Author(s). Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.Introduction: Pregnancy concurrent with incretin-based medications is contraindicated due to unknown risk of teratogenicity, as is breastfeeding. The aim of this systematic scoping review was to investigate potential risks and benefits of incretin-based medications in relation to preconception, pregnancy, and postnatal health, and to propose expert guidelines for clinical practice. Methods: An international expert multidisciplinary group was formed. Research questions relevant to women's reproductive health and incretin-based medications were refined collaboratively, utilizing a lifecourse approach. A systematic search was undertaken on July 23, 2025, across several databases and grey literature sources. Primary data from human studies were prioritized above animal studies. Titles, abstracts, and full text articles were screened independently by two authors. Data were extracted by two people independently using a pre-defined proforma and synthesized narratively. Consensus recommendations were made. Results: Thirty-four articles were included in the evidence synthesis: 11 randomized trials, nine observational studies, two pharmacovigilance reviews, nine case reports/series, two animal studies, and one ex vivo study. No qualitative studies were identified. Evidence was found for 18/32 (56.3%) research questions. Most studies related to preconception or pregnancy usage; two addressed contraception, and one was about lactation. The sample size of exposed pregnancies ranged from 1 to 4267. Three studies reported exposure throughout pregnancy. Three studies investigated postpartum usage. One (animal) study had offspring data beyond birth. No studies reported an increase in congenital anomalies. Conclusion: Clinical practice and research recommendations were made based on current available evidence and evidence gaps, encompassing contraception, preconception, nutritional, pregnancy monitoring, lactation, and longer-term outcomes.
Author(s): Maslin K, Shawe J, Blowers S, Ceulemans M, Hart K, Schoenmakers S, Rottenstreich A, Hopper H, Jensterle M, Flynn AC, Siegelaar S, Bogaerts A, Douek I, Heslehurst N, Ceulemans D, Tan T, Pinkney J, Whyte M, Taheri S, Devlieger R
Publication type: Review
Publication status: Published
Journal: Obesity Reviews
Year: 2026
Pages: epub ahead of print
Online publication date: 29/07/2026
Acceptance date: 09/07/2026
ISSN (print): 1467-7881
ISSN (electronic): 1467-789X
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/obr.70203
DOI: 10.1111/obr.70203
Data Access Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
