Obstetrics & Gynecology

GLP‑1 receptor agonist continuation into first trimester not clearly harmful, estimates imprecise

In a U.S. claims target‑trial emulation of 3,572 pregnancies with GLP‑1RA dispensed before LMP, continuation into the first trimester yielded a weighted nonlive birth risk of 29.7% versus 27.1% with noncontinuation (adjusted RR 1.09, 95% CI 0.98–1.23). Among 2,529 live births, continuation showed no definitive increases in SGA, LGA, or major congenital malformations, but confidence intervals were wide and compatible with clinically important differences. The study is applicable to patients exposed to GLP‑1RAs in early pregnancy but may have residual confounding by prior glycemic control. 1

Pivotal device trials report demographics but rarely embed equity analyses

This scoping review of 74 pivotal device investigations found age and sex were almost always reported, but race/ethnicity appeared in only 35.1% of studies and other PROGRESS‑Plus variables in 9.5%. Few trials incorporated EDI framing in design or analysis (2.7%), and none used CONSORT‑Equity or population benchmarking to assess representativeness. For clinicians and regulators, limited equity integration constrains external validity of device evidence, especially for marginalized groups. 2

Vaginal estradiol with progesterone increases implantation and clinical pregnancy but not live birth

In a single‑center RCT of 518 normal responders on GnRH antagonist IVF/ICSI, adding vaginal 17β‑estradiol to progesterone increased implantation and clinical pregnancy rates. Ongoing pregnancy and live birth did not differ significantly between estradiol plus progesterone versus progesterone alone. Intracytoplasmic pregnancy (ICP) risk was higher with estradiol, so benefits for early pregnancy markers did not translate into clear live‑birth advantage and warrant safety caution. 3