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How COVID-19 Treatment in Pregnancy Reflects Healthcare Utilization During a Pandemic: A Two-Stage Individual
Emeline Maisonneuve1,2,3,4, Odette De Bruin5,6, Guillaume Favre1,7
1Materno-Fetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant", University Hospital, Lausanne, Switzerland.
Pregnant individuals hospitalized with COVID-19 received more medications. Corticosteroid use was lower in early pregnancy, with significant international variations in treatment approaches for this high-risk group.
Area of Science:
- Reproductive Health
- Infectious Diseases
- Pharmacology
Background:
- The COVID-19 pandemic posed significant risks to pregnant individuals, necessitating understanding of treatment patterns.
- International data on medication use for COVID-19 in pregnancy is crucial for informed clinical guidelines.
- Variations in healthcare access and management strategies may influence treatment decisions globally.
Purpose of the Study:
- To estimate the prevalence of medication use for treating COVID-19 in pregnant individuals.
- To stratify medication prevalence by hospitalization status, trimester, and country.
- To analyze international treatment responses during the COVID-19 pandemic in pregnancy.
Main Methods:
- A two-stage individual participant data meta-analysis was performed.
- Data were pooled from 9 international and single-country registries using a common data model.
- Included data from pregnant individuals with COVID-19 between February 2020 and October 2022.
Main Results:
- Among 24,937 pregnant individuals, heparin (34.7%), antibiotics (9.8%), and corticosteroids (4.9%) were most common.
- Medication use was significantly higher in hospitalized versus non-hospitalized pregnant individuals.
- Corticosteroid use was lowest in the first trimester (0.1%) compared to later trimesters; country-specific variations were noted.
Conclusions:
- Hospitalization for COVID-19 increased medication use in pregnant individuals.
- Reduced corticosteroid use in the first trimester suggests cautious management.
- Observed international differences highlight potential disparities in clinical management and medication access for pregnant individuals.
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