(106) GLP-1 Receptor Agonists Associated With Reduced Pelvic Complications in Postpartum Women: A Global Real-World Matched Cohort Study

Abstract Introduction GLP-1 receptor agonists (GLP-1RAs) are increasingly used for weight loss in non-diabetic patients. Postpartum women often experience pelvic health issues such as urinary tract infections (UTIs), inflammatory genital infections, and chronic pelvic pain. Objective To evaluate whether GLP-1RA therapy is associated with reduced rates of postpartum pelvic complications (UTIs, inflammatory genital infections, chronic pelvic pain), independent of weight loss. Methods Using the TriNetX Global Collaborative Network, we conducted a retrospective cohort study of postpartum women, identifying GLP-1RA users (n = 6118) and non-users (n = 283 497). Matching variables were age, body mass index (BMI), hypertension, and race/ethnicity (n = 5387 per group). We compared incidence of UTIs, pelvic pain syndromes (including dyspareunia and vulvodynia), and inflammatory genital infections (eg, vaginitis and vulvitis). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and Kaplan–Meier analysis assessed differences in event-free survival. Results After 1:1 propensity score matching, 5387 patients per group remained. Mean follow-up was 644.8 days for the GLP-1RA group and 1564.4 days for controls. UTI occurred in 4.09% of GLP-1RA users versus 6.94% of controls (OR 0.571, 95% CI 0.461–0.707, p 0.0001). Inflammatory genital infections were diagnosed in 12.85% vs 18.65% (OR 0.605, 95% CI 0.504–0.727, p 0.0001). Pelvic pain syndromes occurred in 7.03% vs 11.98% (OR 0.555, 95% CI 0.465–0.663, p 0.0001); Kaplan–Meier analysis demonstrated significantly longer pelvic pain–free survival in the GLP-1RA group (log-rank p = 0.0315). Conclusions In this large, matched cohort of non-diabetic postpartum women, GLP-1RA use was associated with significantly lower risks of UTIs, pelvic pain syndromes, and genital inflammatory infections. These findings suggest a protective effect of GLP-1RAs on pelvic health in postpartum women beyond weight loss. Disclosure No.