Ozempic-type drugs pose no greater risk to pre-natal infants

Women with type 2 diabetes who use treatments like the popular diabetes drug Ozempic are at no greater risk of their newborn developing congenital problems than those who use insulin, the first major study into their use has found.

It comes amid an expected increase in the use of such ‘second-line’ therapies to treat the disease, particularly with increasing demand for semaglutide drugs like Ozempic and Wegovy, which have also been shown to aid weight loss.

A person with type 2 diabetes will usually be prescribed the drug metformin as a first-line treatment, but if this isn’t tolerated or contraindicated with the use of other medications, a second-line therapy might be considered. Among these are insulin, and several classes of non-insulin antidiabetic medications.

These include medications such as GLP-1 receptor agonists (like semaglutide), sulfonylureas, DPP-4 inhibitors, and SLGT2 inhibitors.

Assistant Professor Carolyn Cesta from the Sweden-based Karolinska Institutet’s Centre for Pharmacoepidemiology, and her team reviewed around a decade of data from 3.5 million pregnancies in the United States, Israel, Sweden, Finland, Iceland and Norway.

From them, about 52,000 women with pregestational type 2 diabetes were isolated, of whom 15,000 were treated with antidiabetic medication around and shortly after conception.

The research, published today in the journal JAMA Internal Medicine, found no elevated risk of abnormalities in newborns from the use of these non-insulin medications, and a slightly reduced risk among a small group using semaglutide.

Previously, data has suggested a slightly higher rate of major congenital malformations in children born to women with pregestational type 2 diabetes than those without. This may be due to poor glycaemic control during pregnancy, which supports the use of appropriate medication to address this.

“As type 2 diabetes becomes a more common condition among women of reproductive age, and with the recent approval of GLP-1 receptor agonists such as semaglutide to treat obesity, the number of exposed pregnancies [to non-insulin medication] is likely to increase,” says Cesta.

“Our findings provide initial reassurance of safety for infants prenatally exposed to these medications.”

However as this is only the first large-scale investigation of the relationship between these drugs in pregnancy and adverse outcomes, the research recommends further study “to fully evaluate the safety of these medications in pregnancy”.