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Cosmos Study

No Rise in Pregnancy Rates in the Year Following GLP-1 Prescription

October 22, 2024
Dual-Team Study
Team A:Kersten Bartelt, RNJoe Deckert, PhD
Team B:Matthew Gracianette, MDBrendan Joyce

Key Findings

  • Pregnancy rates for women aged 18 to 50 who are prescribed GLP-1 medications are similar to those for women who are not prescribed GLP-1 medications.  

There have been anecdotal reports of women unexpectedly becoming pregnant while taking or soon after being prescribed a GLP-1 medication.1,2 While some studies have suggested that GLP-1 medications that delay gastric emptying may make oral contraceptives less effective2, little is known about whether GLP-1 medications are correlated with increased rates of pregnancy.  

To better understand whether women prescribed GLP-1 medications have an increased rate of pregnancy, we studied 27,054 women aged 18 to 50 who were prescribed a GLP-1 medication and matched them by age, BMI, conditions affecting fertility, and history of diabetes to 180,866 women who were not prescribed a GLP-1 medication. We found that the rate of pregnancy in the year following GLP-1 treatment, or a matched visit for women not prescribed a GLP-1 medication, was similar for women who were not prescribed a GLP-1 medication and those who were prescribed semaglutide, liraglutide, tirzepatide, exenatide, or dulaglutide, as shown in Figure 1. 

Figure 1
Pregnancy Rate Within One Year by GLP-1 Treatment
Pregnancy Rate Within One Year by GLP-1 Treatment
Figure 1. Rate of pregnancy in the year following GLP-1 treatment by medication type compared to women without GLP-1 medication use.

These data come from Cosmos, a dataset created in collaboration with a community of Epic health systems representing more than 274 million patient records from 1,500 hospitals and more than 35,500 clinics from all 50 states, Lebanon, and Saudi Arabia. This study was completed by two teams that worked independently, each composed of a clinician and research scientists. The two teams came to similar conclusions. Graphics by Brian Olson. 

References

  1. Camero, K. (2024, March 21). “Ozempic babies” are surprising women taking weight loss drugs. Doctors think they know why. USA Today. https://www.usatoday.com/story/life/health-wellness/2024/03/21/ozempic-pregnancy-weight-loss-drugs-fertility/73032645007/.  
  2. Pawlowski, A. (2023, April 24). Ozempic babies: Weight loss drugs, pregnancy risks, fertility benefits. TODAY. https://www.today.com/health/womens-health/ozempic-pregnancy-fertility-rcna81104.