Ozempic & Wegovy During Pregnancy: 2026 Safety Update

The explosion in GLP-1 receptor agonist prescriptions has created a new clinical reality: millions of women of reproductive age are taking semaglutide (Ozempic, Wegovy) for type 2 diabetes or weight loss, and some are becoming pregnant while on these medications. With new research emerging in 2025-2026, here's what we know now—and what it means if you are pregnant or planning to conceive.

What Are Ozempic and Wegovy?

Both Ozempic and Wegovy contain the same active ingredient: semaglutide, a GLP-1 (glucagon-like peptide-1) receptor agonist. They differ primarily in dose and indication:

• Ozempic: Approved for type 2 diabetes management. Doses up to 2mg weekly.
• Wegovy: Approved for chronic weight management. Doses up to 2.4mg weekly.

Both drugs work by mimicking the GLP-1 hormone, which stimulates insulin secretion, reduces glucagon, slows gastric emptying, and reduces appetite. They have proven highly effective—with Wegovy producing average weight loss of 15-17% in clinical trials.

The "Ozempic Babies" Phenomenon

In 2024 and 2025, fertility clinicians began reporting an unexpected trend: women who had previously struggled to conceive were becoming pregnant after starting GLP-1 medications. This led to the coining of the term "Ozempic babies."

Several mechanisms may explain this:

1. Improved insulin sensitivity: GLP-1 drugs reduce insulin resistance, which can disrupt the hormonal environment needed for ovulation—particularly in women with PCOS.
2. Weight loss improving fertility: Obesity itself impairs fertility. Losing weight can restore more normal hormonal cycles.
3. Reduced oral contraceptive effectiveness: Semaglutide slows gastric emptying, potentially reducing absorption of oral contraceptive pills. This is a critical safety concern that many prescribers were not adequately communicating.

The University Hospitals health system issued guidance in late 2025 noting that women on GLP-1 medications should be counseled about potential interactions with oral contraceptives and may need to use barrier methods or non-oral contraception.

2025-2026 Safety Research: What We Now Know

The Largest Study to Date

A landmark study examining outcomes from over 750,000 pregnancies was published in 2025, providing the most comprehensive safety data yet. Key findings:

• No increased risk of major congenital malformations in semaglutide-exposed pregnancies compared to unexposed pregnancies
• Among women using GLP-1s for weight loss, no connection to preterm birth or major obstetric complications was found
• Among women using GLP-1s for pre-existing type 2 diabetes management, a slightly higher risk of preterm birth was noted—but researchers caution this may reflect the underlying diabetes rather than the drug itself

The NIH/PMC Study on Semaglutide-Exposed Pregnancies

A separate 2025 analysis published in PMC examined pregnancy outcomes specifically in semaglutide-exposed pregnancies versus insulin-exposed and unexposed pregnancies:

• No increased risk of major malformations vs. insulin-exposed pregnancies
• Higher risk of preterm birth, large-for-gestational-age infants, neonatal hypoglycemia, and neonatal jaundice—but these risks were comparable to insulin-exposed pregnancies, not dramatically higher
• Researchers concluded that baseline diabetes risk, not semaglutide specifically, likely drives much of these complications

Animal Studies Still Raise Concerns

FDA labeling for semaglutide notes that animal reproductive studies showed fetal growth reductions and structural abnormalities at doses above clinical exposure levels. While these findings don't necessarily translate to humans, they explain why caution remains the official stance.

FDA Guidance as of 2026

The FDA's current recommendations:

• Stop semaglutide at least 2 months before attempting conception (the drug's half-life means it stays in the body for weeks after the last dose)
• If pregnancy occurs while taking semaglutide, discontinue immediately and contact your healthcare provider
• Semaglutide is not approved for use during pregnancy or lactation
• Women who were pregnant while taking semaglutide can report their exposure at 1-800-727-6500 (Novo Nordisk pregnancy registry)

What About Gestational Diabetes Specifically?

Women sometimes ask whether GLP-1 drugs like Ozempic could be used to treat gestational diabetes, given their glucose-lowering effects. The answer, as of 2026, is no—for several reasons:

1. No approved indication: Semaglutide has not been studied or approved for gestational diabetes treatment
2. Placental transfer: The drug may cross the placenta, with unknown effects on fetal development
3. Appetite suppression concerns: GLP-1 drugs reduce appetite significantly, which could lead to inadequate nutrition during pregnancy
4. Established alternatives: Insulin (and in some cases, metformin) have decades of safety data in pregnancy and work effectively for most women with GD

If You Became Pregnant While Taking Ozempic or Wegovy

If this is your situation, here's what the current evidence and guidelines suggest:

1. Contact your healthcare provider immediately. Do not stop any medication abruptly without guidance—though your provider will almost certainly recommend stopping semaglutide.
2. Don't panic. The most recent large-scale data is reassuring regarding major birth defects, particularly for first-trimester exposures that ended early.
3. Request enhanced monitoring. Given potential risks including preterm birth, ask about additional ultrasound monitoring.
4. Discuss your diabetes management plan. If you were on Ozempic for type 2 diabetes, you'll need an alternative treatment (almost certainly insulin) for the duration of your pregnancy.
5. Ask about enrollment in the pregnancy registry. Your participation helps researchers build the evidence base that will protect future pregnancies.

The Pregnancy Registry: Why It Matters

Both Novo Nordisk (Ozempic/Wegovy) and Eli Lilly (Mounjaro/Zepbound) have established pregnancy registries to collect real-world data on outcomes. These registries are critical because:

• Randomized clinical trials cannot ethically enroll pregnant women for drug safety testing
• Real-world data from accidental exposures provides the only human safety evidence available
• As the number of GLP-1 users grows, the registry will accumulate enough cases to detect even rare outcomes

What to Ask Your Doctor

• I was taking semaglutide and just found out I'm pregnant—what should I do right now?
• What additional monitoring do you recommend given my exposure?
• What should I use instead to manage my blood sugar during pregnancy?
• Should I enroll in the Novo Nordisk pregnancy registry?
• If I want to get pregnant in the future, how far in advance should I stop semaglutide?

For more on glucose management during pregnancy, see our guide to the best glucose monitors for pregnancy in 2026 and our overview of metformin vs. insulin for gestational diabetes.

This content is for informational purposes only and is not medical advice. Always consult your healthcare provider or registered dietitian for personalized guidance.