Abstract Type 2 diabetes mellitus (T2DM) and obesity are increasingly prevalent among women of reproductive age and are associated with adverse maternal and neonatal outcomes. Tirzepatide, a dual glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptor agonist, has demonstrated significant benefits in glycemic control and weight reduction; however, its safety profile in pregnancy remains uncertain, with animal studies suggesting potential risks. We report the case of a 36-year-old woman with T2DM, morbid obesity, chronic kidney disease, and polycystic ovarian syndrome who conceived inadvertently while on tirzepatide, dapagliflozin, and metformin, continuing therapy until the 31st week of gestation. Despite multiple comorbidities and prolonged exposure to tirzepatide, the patient remained clinically stable and underwent an emergency Cesarean section at 37 weeks, delivering a live female infant. The neonate exhibited no congenital anomalies or major complications, apart from mild tongue tie and a slightly reduced abdominal circumference and birth weight. This case highlights the necessity of preconception counseling and education for the use of tirzepatide in patients of childbearing age due to its easy and wide availability. Moreover, it provides preliminary reassurance regarding the safety of tirzepatide during pregnancy, but larger studies are needed to establish maternal and neonatal outcomes with certainty.
Ahmed et al. (Fri,) studied this question.