Pregnancy outcomes after inadvertent exposure of anti-obesity drugs during pregnancy

Abstract

Pregnancy outcomes after inadvertent exposure of anti-obesity drugs during pregnancy Eun Jeong Choi1 , Jung Yeol Han1, * 1Department of Obstetrics and Gynecology, Inje University Ilsan Paik Hospital, Korean MotherSafe Counselling Centre, 10380 Goyang City, Korea *Correspondence: hanjungyeol055@gmail.com (Jung Yeol Han) DOI:10.31083/j.ceog.2021.03.2331 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 21 October 2020 Revised: 26 February 2021 Accepted: 5 March 2021 Published: 15 June 2021 Backgrounds: To improve health, an increasing number of adults are attempting to lose weight. Moreover, the number of childbearing women targeting weight loss has increased, with a surge in pregnant women exposed to anti-obesity drugs. This study aimed to evaluate the ingredients, types, and trends of anti-obesity drugs and pregnancy outcomes among the exposures of anti-obesity drugs. Additionally, we reviewed their teratogenicity in literature. Methods: We performed a prospective cohort study and recruited pregnant women exposed to anti-obesity drugs in the Motherisk Database, from 2012 to 2018. We determined the frequency and type of antiobesity drugs used. Furthermore, we compared the annual change in the frequency of anti-obesity drugs with that of total pregnancies. Overall, 30,704 pregnant women were enrolled during the study period. Results: The rate of pregnant women exposed to antiobesity drugs was 4.8% (1487/30,704). The rate of pregnant women exposed to anti-obesity drugs significantly increased from 3.7% in 2012 to 7.4% in 2018 (p < 0.001). The most frequently used drugs were phentermine (33.0%) and phendimetrazine (25.9%). The number of pregnant women exposed to anti-obesity drugs has recently increased. There is no difference in pregnancy outcomes between the exposure and the un-exposure of anti-obesity drug except that birth weight and large for gestational age are significantly larger in the exposure group. Additionally, there are no difference of abnormalities between the exposure (3.1%) and the un-exposure of antiobesity drugs (3.7%). Discussion: This study showed that the exposure of anti-obesity drug profoundly increased during the study period and there exist known teratogenic drugs. Therefore, childbearing women should be concerned with preventing teratogenic effects following anti-obesity drug exposure during pregnancy. Physicians should warn childbearing women about potential dangers of antiobesity drug. Keywords Pregnancy; Anti-obesity drugs; Teratogen; Obesity; Overweight