How Bioethics and Reproductive Justice Ought to Inform Glucagon-Like Peptide-1 Receptor Agonists, Research, and Pregnancy.

PubMed1 Apr 2026·Obesity reviews : an official journal of the International Association for the Study of Obesity● 2/10i

How Bioethics and Reproductive Justice Ought to Inform Glucagon-Like Peptide-1 Receptor Agonists, Research, and Pregnancy.

Pondugula N, Merriam AA

Bioethics researchers argue that pregnant people are systematically excluded from GLP-1 receptor agonist studies, creating evidence gaps that prevent understanding of safety and efficacy during pregnancy. Theoretical framework analysis applying reproductive justice principles to GLP-1RA research methodology. This highlights a regulatory and commercial challenge facing all GLP-1RA manufacturers as pregnancy safety data remains limited across the drug class.

Strategic signal

FDA pregnancy labeling requirements for GLP-1RAs remain unchanged without actual clinical data. This theoretical framework could influence future trial design discussions at advisory committee meetings, but regulatory agencies prioritize clinical evidence over ethical positioning papers. The practical impact on Novo Nordisk and Eli Lilly's pregnancy research strategies depends on whether bioethics committees at major academic centers adopt these frameworks when reviewing protocols.

GLP-1

Original Abstract

There are large evidence gaps for pregnant people, and research in pregnancy should be prioritized to ensure strong evidence to guide safe clinical practice. GLP-1 receptor agonist (GLP-1RA) research is a modern example that shows how pregnancy continues to preclude individuals from participating in and subsequently receiving potential benefits of research or understanding their important effects. In this article, we utilize GLP-1RAs to practically discuss prior ethical work on research in pregnancy, we specifically apply Miranda Waggoner and Anne Lyerly's framework of the protectionist ethic to the case of GLP-1RA research, and we consider risk as well as potential maternal and fetal benefit as they relate to GLP-1RAs. Finally, reproductive justice as an organizing theoretical framework offers many important insights into critically evaluating research, pregnancy, and GLP-1RAs and should be centered throughout research in pregnancy efforts. Strong ethical analyses, rooted in reproductive justice, are critical to informing clinical science in pregnant humans to narrow the evidence gaps, including with GLP-1RAs.

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