Systematic review used seven studies of for meta-analysis, encompassing more than 43,000 women with diabetes exposed to GLP-1 RAs

Evidence suggests that first-trimester exposure to GLP-1RAs is not associated with an increased risk of congenital anomalies, preterm birth, hypertensive disorders of pregnancy, stillbirth, neonatal death, caesarean delivery, or small-for-gestational-age birth

Early pregnancy loss, including miscarriage or termination, was 31% more common among women exposed to GLP-1 RA, however this outcome only included two studies, where termination of pregnancy by choice and loss by miscarriage were combined as one outcome making interpretation difficult

The authors’ consensus supports GLP-1RA use for preconception metabolic optimisation (making women as healthy as possible), especially in women with T2D, while emphasising stopping use before planned pregnancy

There is an urgent need for prospective studies evaluating maternal, fetal and long-term outcomes in women living with diabetes and using GLP-1 RAs – including key issues such as women who are breastfeeding and wanting to control their diabetes/lose weight using these drugs

Authors emphasise that across all areas investigated, stronger evidence is required and that their conclusions while mostly positive are based on observational evidence and expert opinion – and should be interpreted with caution until further evidence emerges

Daniel Kruger, research associate professor in the School of Public Health and Health Professions at the University at Buffalo, launched a study with Paul Gillis-Smith, program lead at the Center for the Study of World Religious Studies at Harvard Divinity School, in which they surveyed almost 600 self-identified psychedelic users. Their findings, which showed that participants agreed with 18 of 19 pieces of Lisa Bieberman’s advice on best practices for LSD and other psychedliecs use, were published in the Aug. 12 edition of the journal Psychedelics.