Yeri Estu RISUNANG, Luga MARJONO, Tita HUSNITAWATI
Perinatal Journal - 2026;34(2):6-18
Polycystic Ovary Syndrome (PCOS) affects an estimated 8-13% of reproductive-aged women and is frequently accompanied by obesity and insulin resistance, increasing cardiometabolic risk. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may address these features, but comparative evidence in PCOS remains heterogeneous. We systematically searched PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library from inception to January 3, 2026 for comparative studies evaluating GLP-1RAs in women with PCOS. Random-effects meta-analyses were conducted using standardized mean differences (SMD) for continuous outcomes and risk ratios (RR) for adverse events. Heterogeneity was quantified using I². Risk of bias was assessed using ROBINS-I by independent reviewers with discrepancies resolved through discussion. Thirteen studies were included. GLP-1RAs improved abdominal girth (SMD -0.58; I²=0%), BMI (SMD -1.14; I²=92.5%), body weight change (SMD -1.24; I²=93.4%), waist circumference (SMD -1.37; I²=94.7%), glucose homeostasis (SMD -0.72; I²=86.1%), and hormonal parameters overall (SMD -0.36; I²=89.7%). The pooled effect for lipid profile was SMD -0.12 (p=0.060; I²=53.1%). Safety analyses showed higher nausea (RR 2.20; I²=17.2%) and diarrhea (RR 2.17; I²=40.6%) with GLP-1RAs. In women with PCOS, GLP-1RAs were associated with improvements in anthropometric and glycemic outcomes, with gastrointestinal adverse events occurring more frequently.
