{"id":"1ae9b0d74409","type":"article","url":"https://hartvaat.nl/2026/10/10/preconceptie-glp-1-gip-agonisten-verlagen-zwangerschapscomplicaties-en-cardiomet/","title":"Preconceptie GLP-1/GIP-agonisten verlagen zwangerschapscomplicaties en cardiometabole risico’s bij PCOS","title_en":"Preconception incretin therapy reduces pregnancy and cardiometabolic outcomes in polycystic ovary syndrome.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"The Journal of clinical endocrinology and metabolism","doi":"10.1210/clinem/dgag423","source_url":"https://doi.org/10.1210/clinem/dgag423","authors":["Alex E Henney","Phoebe J Holmes","David Riley","Megan Heague","Dharani K Hapangama","Uazman Alam","Daniel J Cuthbertson"],"significance":5,"published":"2026-10-18","source_date":"2026-10-10","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/glp1-agonisten-cardiologie/","https://hartvaat.nl/kennis/hartfalen/betablokkers-bij-hartfalen/"],"congress":"","summary_en":"A target trial emulation using a large federated database (TriNetX; n=96,252) found that preconception use of GLP-1 or dual GLP-1/GIP receptor agonists in women with PCOS/PMOS was associated with a significantly lower risk of composite adverse pregnancy outcomes compared with metformin (HR 0.38). Exploratory analyses also showed reduced rates of major adverse cardiovascular events (HR 0.88) and type 2 diabetes (HR 0.31). These findings support the value of preconception metabolic optimisation, but the authors explicitly caution that the data do not support using these agents during gestation due to unknown foetal safety.","created":"2026-10-12T01:06:23Z","updated":"2026-10-12T01:06:23Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een retrospectieve cohortstudie met propensity score-matching in een grote federatieve database (n=96.252) toont aan dat preconceptiegebruik van GLP-1- of dual GLP-1/GIP-receptoragonisten bij vrouwen met PCOS/PMOS gepaard gaat met een aanzienlijk lager risico op een samengestelde uitkomst van zwangerschapscomplicaties (HR 0,38) vergeleken met metformine. Daarnaast werden lagere incidenties van MACE (HR 0,88) en type-2-diabetes (HR 0,31) waargenomen. De bevindingen ondersteunen het concept van preconceptie-metabole optimalisatie, maar benadrukken dat deze middelen niet tijdens de zwangerschap zelf gebruikt mogen worden vanwege onbekende foetale veiligheid.","abstract_original":"BACKGROUND: Polycystic ovary syndrome (PCOS), now polyendocrine metabolic ovarian syndrome (PMOS), is associated with reproductive and cardiometabolic complications. Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) receptor agonists (RAs) improve obesity-related outcomes, but their impact on pregnancy outcomes in PMOS remains unclear. METHODS: We conducted a target trial emulation using the TriNetX global federated health research network. Women ≥18 years with PCOS/PMOS receiving pre-conception GLP-1/dual GLP-1/GIP RA therapy (liraglutide, semaglutide or tirzepatide) were compared with metformin. Propensity score matching (1:1) accounted for demographics, anthropometrics, comorbidities and medications. The primary outcome was a composite of adverse pregnancy outcomes (hypertensive, glycaemic, placental, delivery, labour, foetal growth, preterm and early pregnancy complications) over two years. Individual pregnancy endpoints, major adverse cardiovascular events (MACE) and type 2 diabetes (T2D) were exploratory secondary outcomes. Cox regression generated hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: After matching, 48,126 patients were included per group. Pre-conception GLP-1/GIP RA use was associated with lower risk of the composite pregnancy outcome (HR 0.38; 95% CI 0.34-0.41). Exploratory analyses also demonstrated lower risks of individual pregnancy endpoints, MACE (HR 0.88; 95% CI 0.81-0.95) and T2D (HR 0.31; 95% CI 0.30-0.33). Associations varied across some sensitivity analyses. CONCLUSION: Pre-conception GLP-1/GIP RA use in women with PCOS/PMOS was associated with lower risks of adverse pregnancy outcomes and cardiometabolic disease compared with metformin, consistent with potential benefits of pre-conception metabolic optimisation. This study cannot evaluate in-pregnancy safety or efficacy, and these findings do not support GLP-1/GIP RA use during gestation."}