Incidence of GLP-1 receptor agonist use by women of reproductive age attending general practices in Australia, 2011–2022: a retrospective open cohort study

IF 8.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medical Journal of Australia Pub Date : 2025-09-01 DOI:10.5694/mja2.70026

Kailash Thapaliya, Arianne Sweeting, Kirsten I Black, Amanda Poprzeczny, Danielle Mazza, Luke E Grzeskowiak

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Abstract

Objective

To examine longitudinal changes in the initial prescribing of glucagon-like peptide 1 (GLP-1) receptor agonists for women of reproductive age in Australia; to determine whether contraception recommendations are being followed; and to estimate the frequency of pregnancy among women using GLP-1 receptor agonists.

Study design

Retrospective open cohort study; analysis of MedicineInsight general practice data.

Setting, participants

Women aged 18–49 years who visited participating general practices three or more times during the study period (1 January 2011 – 31 July 2022).

Main outcome measures

Age-standardised incidence of initial GLP-1 receptor agonist prescribing, by year and type 2 diabetes status; proportion of women using highly effective contraception at the time of GLP-1 receptor agonist initiation (contraception overlap); age-standardised incidence of pregnancy within six months of the first prescribing of GLP-1 receptor agonists.

Results

Of 1 635 684 women aged 18–49 years, 18 010 (1.1%) were first prescribed GLP-1 receptor agonists during 2011–2022, of whom 3739 (20.8%) had type 2 diabetes. The age-standardised incidence of GLP-1 receptor agonist prescribing for women with type 2 diabetes increased from 13.0 per 1000 women in 2011 to 88.5 per 1000 women in 2022; for women without type 2 diabetes, it increased from 0 to 14.9 per 1000 women. Of the 6293 women first prescribed GLP-1 receptor agonists during 2022, 6954 (90.5%) did not have type 2 diabetes. Contraception overlap with first prescribing of GLP-1 receptor agonists was determined for 3825 women (21.2%). Pregnancies within six months of GLP-1 receptor agonist prescribing were documented for 232 of 10 781 women for whom at least six months of follow-up data were available.

Conclusions

The prescribing of GLP-1 receptor agonists for women of reproductive age is increasing in Australia, and most prescriptions are for women not diagnosed with type 2 diabetes. Fewer than one in four women are using contraception at the time of treatment initiation, and a considerable number are pregnant within six months of the initial prescribing of GLP-1 receptor agonists. Further evidence and guidelines are needed to support the safe and effective use of GLP-1 receptor agonists by women of reproductive age.

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2011-2022年澳大利亚参加全科诊所的育龄妇女GLP-1受体激动剂使用的发生率：一项回顾性开放队列研究

目的：探讨澳大利亚育龄妇女胰高血糖素样肽1 （GLP-1）受体激动剂初始处方的纵向变化；确定避孕建议是否得到遵循；并估计使用GLP-1受体激动剂的妇女的怀孕频率。研究设计：回顾性开放式队列研究；MedicineInsight全科实践数据分析。背景，参与者：在研究期间（2011年1月1日至2022年7月31日），年龄在18-49岁、到参与研究的全科诊所就诊三次或以上的女性。主要结局指标：GLP-1受体激动剂初始处方的年龄标准化发生率，按年份和2型糖尿病状况分列；在GLP-1受体激动剂启动时使用高效避孕措施的妇女比例（避孕重叠）；首次使用GLP-1受体激动剂后6个月内妊娠的年龄标准化发生率。结果：在1 635 684名年龄在18-49岁的女性中，2011-2022年期间，18010名（1.1%）首次服用GLP-1受体激动剂，其中3739名（20.8%）患有2型糖尿病。2型糖尿病女性GLP-1受体激动剂处方的年龄标准化发病率从2011年的13.0 / 1000女性增加到2022年的88.5 / 1000女性；对于没有2型糖尿病的女性，死亡率从0‰上升到14.9‰。在2022年期间，6293名首次服用GLP-1受体激动剂的女性中，6954名（90.5%）没有2型糖尿病。3825名妇女（21.2%）首次使用GLP-1受体激动剂时确定避孕重叠。10781名至少有6个月随访数据的妇女中，有232人在服用GLP-1受体激动剂后6个月内怀孕。结论：澳大利亚育龄妇女GLP-1受体激动剂处方增加，且大多数处方为未诊断为2型糖尿病的妇女。不到四分之一的妇女在治疗开始时使用避孕措施，相当多的妇女在最初使用GLP-1受体激动剂的六个月内怀孕。需要进一步的证据和指南来支持育龄妇女安全有效地使用GLP-1受体激动剂。

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来源期刊

Medical Journal of Australia 医学-医学：内科

CiteScore

9.40

自引率

5.30%

发文量

410

审稿时长

3-8 weeks

期刊介绍： The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.