Semaglutide, a glucagon-like peptide-1 receptor agonist, is increasingly used for the treatment of diabetes and weight loss, including in women of reproductive age. However, its impact on pregnancy outcomes remains largely unknown, with limited data available. The manufacturer advises against using semaglutide within two months prior to planned pregnancy, but some patients may unknowingly use it during early pregnancy.

We report the case of a 37-year-old woman with a pre-pregnancy Body Mass Index (BMI) of 27.73 kg/m². She received semaglutide 0.5 mg once weekly, initiated before conception and continued until approximately 7 weeks of gestation, and discontinued treatment immediately upon recognition of pregnancy. All prenatal screenings, including nuchal translucency and four-dimensional color Doppler ultrasound, were normal. She delivered a healthy male infant at nearly 40 weeks of gestation. The infant showed no adverse outcomes during follow-up assessments at 1 and 3 months of age.

This case suggests that semaglutide exposure during early pregnancy may not necessarily lead to adverse outcomes in obese women. However, larger studies are needed to confirm these findings and to better understand the impact of semaglutide on pregnancy outcomes. This case report contributes to the limited literature on this topic and may inform future clinical decision-making.