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Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data
Odette de Bruin1,2, Emeline Maisonneuve3,4,5, Eimir Hurley6
1Department of Data Science & Biostatistics, Julius Global Health, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands.
Aim:
To estimate the prevalence of medication use in nonhospitalized pregnant women with COVID-19.
Methods:
A prospective two-stage individual patient meta-analysis across 10 data sources in Europe and North America studied medication use among nonhospitalized pregnant women with COVID-19 between January 2020 and December 2022. Comparisons were made between medication use within 30 days pre- and post-COVID-19 diagnosis in this cohort and two comparator groups: pregnant women without COVID-19 and nonpregnant women with COVID-19. Prevalence estimates were pooled using a random-effects model stratified by trimester.
Results:
50 335 nonhospitalized pregnant women with COVID-19 were identified. The pooled prevalence of antibacterial use in the third trimester was higher post-COVID-19 diagnosis (6.8%, 95% confidence interval [CI] = 5.5-8.4, I2 = 94%) compared with the same women pre-COVID-19 (3.9%, 95% CI = 3.1-4.9, I2 = 89%). Overall, pregnant women with COVID-19 had higher medication use compared to pregnant women without COVID-19, although the CIs of the prevalence overlapped. Post-COVID-19, antithrombotic prevalence was 4.5% (95% CI = 1.1-16.5, I2 = 100%) among pregnant women with COVID-19 in the third trimester, compared to 2.1% (95% CI = 1.2-3.6, I2 = 99%) among those without COVID-19 in the third trimester. Compared to nonpregnant women with COVID-19, pregnant women with COVID-19 were less likely to be prescribed analgesics, antiprotozoals, corticosteroids, psychoanaleptics and psycholeptics, and more likely to be prescribed antithrombotics, cough and cold and nasal preparations, and drugs used in diabetes across all trimesters. High heterogeneity existed in nearly all analyses.
Conclusion:
This international meta-analysis reveals low medication use and country-specific variations, enhancing insight into the management of COVID-19 in nonhospitalized pregnant women. Higher antithrombotic use post-COVID-19 suggests prophylactic treatment in this population, but variation between countries emphasizes the challenges of combining multinational data.
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