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

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.