When women taking weight loss jabs stop their use because of pregnancy, the rebound weight gain brings health risks for their babies.
Women who paused the injections before or shortly after conceiving were more likely to gain excess weight in pregnancy, a study has found.
This made them more likely to develop diabetes or high blood pressure in the pregnancy, which carries risks for both the mum and child.
Use of weight loss injections has been soaring over the past two years, with over 1.5 million people in the UK currently taking Wegovy (also known as semaglutide and Ozempic) or Mounjaro (tirzepatide), mainly from online pharmacies.
Some people are also getting them through NHS obesity clinics, although this requires meeting strict weight and health criteria to be eligible.
The injections, which work by mimicking a hormone called GLP-1 that makes us feel full, are designed to be used long term. People who stop taking them usually regain their weight.
Women are advised to stop the jabs before getting pregnant, because studies in animals have suggested the drugs could cause birth defects.
If women get pregnant accidentally, they should stop the injections straight away. “There’s not enough information about their safety for unborn babies,” said Dr Jacqueline Maya, a paediatric endocrinologist at Mass General Brigham for Children, a hospital in Boston.
But it was unclear how any rebound weight gain from stopping the jabs would impact the pregnancy. Women normally gain up to two stone by the end of their pregnancy, some of which is from gaining extra fat tissue, as well as from the baby and placenta.
To investigate, Dr Maya’s team tracked the health of nearly 1,800 pregnant women.
One quarter of them had been using Wegovy or a similar medicine either when they first conceived or in the three years before conception. The other women were selected because they were similar in characteristics like weight and health, and so could be used as a comparison group.
The injection users gained seven pounds more during their pregnancy than those in the comparison group. And 65 per cent of the injection users were classed as having put on too much weight, compared with 49 per cent in the comparison group.
As the injection users weighed the same as those in the comparison group at the start of pregnancy, this suggests their extra weight gain was a rebound effect from stopping the jabs.
Big baby can mean a difficult birth
The injection users were also more likely to develop gestational diabetes, with rates of 20 and 15 per cent respectively. This condition, which is when the mum’s blood sugar gets too high, raises the risk of a big baby and a difficult birth.
The injection users were also more likely to have high blood pressure (46 compared with 36 per cent), which can trigger seizures in the mother. And they were more at risk of giving birth prematurely (17 compared with 13 per cent).
“Additional studies are needed on the balance of pre-pregnancy benefits of GLP-1s with the risks [of] interrupting them for pregnancy,” said Dr Camille Powe, an endocrinologist at Mass General Brigham, who was also involved in the study.
“We need to do more research to find ways to help manage weight gain and reduce risks during pregnancy when stopping GLP-1 medications.”
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The NHS website advises pregnant women that “putting on too much weight can affect your health and increase your blood pressure. But pregnancy isn’t the time to go on a diet, as it may harm the health of the unborn child.”
The study was published in the journal, JAMA.
Novo Nordisk, the manufacturer of Wegovy, was approached for comment.
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