AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Postpartum Timing of GLP-1 Receptor Agonist Therapy and Cardiometabolic Risk Trajectories in the Perinatal Period
By Morales Lopez C, Verastegui Davila A, Coutinho MV et al.
Background: Postpartum weight retention is associated with higher cardiovascular disease risk and adverse pregnancy outcomes in subsequent pregnancy. GLP-1 receptor agonists (GLP-1RAs) are effective for weight loss and are increasingly used among women of reproductive age before and after pregnancy, however limited data exists on its impact on health outcomes when used during the postpartum period, a critical timepoint for targeted risk reduction interventions. Research Question: Does GLP-1RA initiation timing within the first-year post-partum affect cardiometabolic risk trajectories? Methods: We conducted a retrospective cohort study of women initiating GLP-1RAs within the first year postpartum. Data, including weight and blood pressure, were systematically extracted from the electronic medical record of a single health system from December 2018, through December 2025. Patients were categorized as early (<6 months postpartum) or late (≥6 months postpartum) users based on the timing of GLP-1RAs initiation. The primary outcome was time to ≥10% weight loss. Within the subgroup of patients with hypertensive disorders of pregnancy (HDP), we also evaluated time to systolic blood pressure (SBP) reduction of ≥10 mmHg. Analyses were performed using Kaplan-Meier curves and Cox proportional hazard regression models, adjusted for type 2 diabetes, sleep apnea, and body mass index (BMI) ≥ 30 kg/m ² . Results: We identified 704 women with a documented delivery date and GLP-1RAs initiation within 12 months following delivery. The median age was 33.0 years (IQR: 29.0-36.0) and median BMI was 39.6 kg/m2 (IQR: 35.2-44.8). The prevalence of type 2 diabetes, HDP, and pre-pregnancy obesity was 16.2% (114/704), 61.1% (430/704), and 87.4% (553/633) respectively. Within this cohort, 297 (42.2%) were classified as early users, and 407 (57.8%) as late users. Early users achieved earlier and greater sustained weight loss (≥ 10% reduction in body weight) compared with late users (Figure 1A), adjusted HR: 2.64 (95% CI: 2.00-3.47), p <0.01. Among women with HDP (n=430), early users showed a trend toward earlier and greater sustained SBP reduction (≥ 10 mmHg), compared with late users though this did not reach statistical significance (Figure 1B), adjusted HR: 1.19 (95% CI: 0.95-1.49), p=0.13. Conclusion: Early GLP-1RAs use was associated with earlier and greater sustained postpartum weight loss compared with late use. The absence of a similar early trajectory among late users demonstrates benefits beyond expected postpartum weight loss and fluid shifts. Early use also suggests more favorable SBP trajectories, highlighting its potential role in improving postpartum cardiometabolic health. Larger systematic studies are needed to confirm these findings and evaluate effects on infant outcomes as well as long-term cardio-kidney-metabolic risk in women.