Obstetrics & Gynecology

GLP-1 receptor agonist exposure before/early pregnancy not linked to major maternal complications

Meta-analysis of eight studies (186,598 pregnancies; 47,159 exposed) found no significant difference in gestational diabetes (OR 0.99; 95% CI, 0.61–1.61). No significant associations were seen for preterm birth (OR 1.01; 95% CI, 0.76–1.33), preeclampsia, or hypertensive disorders. Leave-one-out sensitivity suggested a possible protective effect against gestational diabetes (OR 0.81; 95% CI, 0.67–0.98). Heterogeneity and variable study quality limit certainty; these findings are hypothesis-generating, not definitive. 1

TangMama telemedicine for GDM improved glycemic control and reduced perinatal complications

In a real-world prospective cohort (n=4,621; 1,711 telemedicine), TangMama plus standard care lowered third-trimester HbA1c (adjusted mean difference -0.05%). Telemedicine was associated with reduced gestational weight gain and lower odds of cesarean, hypertensive disorders, and preeclampsia. Neonatal outcomes improved, including lower preterm birth (aOR 0.47) and fewer NICU admissions and neonatal hypoglycemia. Dose–response analyses showed greater engagement yielded larger benefits, but residual confounding remains possible. 2

Infertile women show higher reproductive tract alpha-diversity and lower Lactobacillus abundance

Systematic review and meta-analysis of 27 studies (2,174 participants) found higher vaginal α-diversity (Shannon SMD 0.27) in infertile women. Lactobacillus abundance was lower (SMD -0.40), while Prevotella and Burkholderia were relatively increased. Microbial differences were most prominent in vaginal samples and β-diversity differed in most studies. Evidence is low to very low certainty and observational; causality and therapeutic implications remain unproven. 3