撰文丨王聪 编辑丨王多鱼 排版丨水成文 不良的宫内环境暴露可诱导表观遗传重编程，并在关键发育阶段改变基因表达，从而增加将来患慢性疾病的风险。妊娠期最常见的并发症—— 妊娠期糖尿病 （GDM） 等 宫内高糖 （Intrauterine hyperglycemia，IUHG） 会对后代健康产生深远且持久的影响。然而，IUHG 对后代生殖系统不良影响的分子机制，在很 大程度上仍未被探索。 2025 年 9 月 9 日， 黄荷凤 院士团队等在 Cell Discovery 期刊 发表了题为： Intrauterine hyperglycemia impairs mouse primordial germ cell development and fertility by sex-specific epigenetic reprogramming interference 的研究论文。 不良的宫内环境 （例如 宫内高糖 ） 会损害有性生殖和物种延续，但其潜在机制，目前仍知之甚少。 原始生殖细胞 （PGC） 是将来形成 卵子 和 精子 的"种子细胞"，其正常发育和表观遗传重编程是保证生殖健康和物种延续的关键环节。在这项最 ...

Core Viewpoint - The article discusses the safety concerns and recommendations regarding the use of GLP-1 medications during pregnancy and breastfeeding, highlighting the need for caution and further research in this area [1][3]. Group 1: Research on GLP-1 Medications and Pregnancy - A large study published in January 2024 in JAMA Internal Medicine tracked around 50,000 children born to mothers with type 2 diabetes who used GLP-1 or insulin in early pregnancy, finding no increased risk of congenital defects compared to insulin use [5]. - Another study published in 2023 reviewed 39 independent studies on the effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and breastfeeding, concluding that there is extremely limited information on their safety [6]. Group 2: Risks Associated with GLP-1 Use During Pregnancy - Potential risks of GLP-1 medications during pregnancy may include miscarriage, low birth weight, and congenital defects, primarily due to their impact on maternal food intake and weight gain [6][7]. - Although concerns are mainly based on animal studies, the lack of human research has led to recommendations for discontinuation during pregnancy [7]. Group 3: Recommendations for Women Planning to Become Pregnant - Women are advised to stop using any GLP-1 medications at least two months before attempting to conceive, along with adopting additional preconception lifestyle measures [8]. - The American Diabetes Association recommends insulin as the preferred medication for managing diabetes during pregnancy, while other diabetes medications like metformin and glipizide are not first-line treatments due to their placental transfer [7][8]. Group 4: Breastfeeding Considerations - There is insufficient research to determine the safety of GLP-1 medications during breastfeeding, leading to recommendations against their use during this period [9][10].