How COVID-19 Treatment in Pregnancy Reflects Healthcare Utilization During a Pandemic: A Two-Stage Individual Participant Data Meta-Analysis Combining Case-Based Registries

Emeline Maisonneuve, Materno-Fetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant", University Hospital, Lausanne, Switzerland.
Odette De Bruin, Department of Data Science and Biostatistics, Julius Global Health, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands.
Guillaume Favre, Materno-Fetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant", University Hospital, Lausanne, Switzerland.
Erin Oakley, Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Jenny Yeon Kim, Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Fouzia Farooq, Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Nouf Al-Fadel, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.
Abdulaali Almutairi, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.
Maria Del Mar Gil, Hospital Universitario de Torrejón, Madrid, Spain.
Irene Fernandez Buhigas, Hospital Universitario de Torrejón, Madrid, Spain.
Silvia Visentin, University of Padova, Padova, Italy.
Erich Cosmi, University of Padova, Padova, Italy.
Fernanda Surita, Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil.
Renato T. Souza, Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil.
José G. Cecatti, Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil.
Maria Laura Costa, Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil.
Jose Sanin-Blair, Universidad Pontificia Bolivariana, Fundared-Materna, Medellín, Colombia.
Jorge E. Tolosa, Universidad Pontificia Bolivariana, Fundared-Materna, Medellín, Colombia.
Eran Hadar, Helen Schneider Hospital for Women, Rabin Medical Center, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel.
Anna Goncé, Maternal-Fetal Medicine Department, BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
Christophe Poncelet, Department of Obstetrics and Gynecology, Hôpital NOVO Site de Pontoise, Cergy-Pontoise, France.
Fabienne Forestier, Department of Obstetrics and Gynecology, Hôpital NOVO Site de Pontoise, Cergy-Pontoise, France.
Thibaud Quibel, Department of Obstetrics, Maternité Poissy Saint Germain, Poissy, France.
Begoña Martinez de Tejada, Obstetrics Division, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, and Faculty of Medicine, Geneva, Switzerland.
Béatrice Eggel-Hort, Materno-Fetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant", University Hospital, Lausanne, Switzerland.
Romina Capoccia Brugger, Department of Obstetrics and Gynecology, RHNE, Neuchâtel, Switzerland.
Daniel Surbek, Department of Obstetrics and Feto-Maternal Medicine, University Hospital of Bern, University of Bern, Bern, Switzerland.
Luigi Raio, Department of Obstetrics and Feto-Maternal Medicine, University Hospital of Bern, University of Bern, Bern, Switzerland.
Anda-Petronela Radan, Department of Obstetrics and Feto-Maternal Medicine, University Hospital of Bern, University of Bern, Bern, Switzerland.
Monya Todesco-Bernasconi, Department of Obstetrics and Gynecology, Cantonal Hospital Aarau, Aarau, Switzerland.
Cécile Monod, Department of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland.
Leonard Schäffer, Division of Obstetrics, Baden Cantonal Hospital, Baden, Switzerland.

Document Type

Journal Article

Publication Date

7-1-2025

Journal

Pharmacoepidemiology and drug safety

Volume

34

Issue

7

DOI

10.1002/pds.70180

Keywords

CONSIGN group; COVID‐19; medication use; meta‐analysis; pregnancy

Abstract

PURPOSE: To describe an international response to the COVID-19 pandemic by estimating the prevalence of medication use for COVID-19 treatment in pregnancy, stratified by hospitalization, trimester of pregnancy, and country. METHODS: We conducted a two-stage individual participant data meta-analysis of proportions from primary data on medications used to treat COVID-19 during pregnancy. A common data model was developed to pool the data from single-country and international registries. Data from pregnant individuals with COVID-19 between February 2020 and October 2022 were included in study platforms across 9 data sources. Patient information was abstracted from medical records. RESULTS: Among 24 937 pregnant individuals, the pooled prevalences of individuals receiving medications to treat COVID-19 were: 34.7% heparin, 9.8% antibiotics, 4.9% corticosteroids, 2.2% antivirals, 0.8% antimalarials, 0.3% convalescent plasma, 0.2% immunosuppressants, and 0.02% monoclonal antibodies. Prevalence of medication use was higher in hospitalized individuals than in non-hospitalized individuals: 58.4% versus 17.9% for heparin, 26.9% versus 5.7% for antibiotics, 17.5% versus 1.3% for corticosteroids, 10.3% versus 0.3% for antivirals, and 4.5% versus 0.1% for antimalarials. The prevalence of corticosteroid use was lower in the first trimester (0.1%) compared with the second (7.2%) and third (4.9%) trimesters of pregnancy. The prevalence of medications differed widely across countries. CONCLUSION: Medication to treat COVID-19 was more frequently used in pregnant individuals hospitalized for COVID-19. Corticosteroids were used less in the first trimester of pregnancy. The differences in use between countries could reflect differences in the clinical management and access to medications for this population at risk of severe disease.

Department

Global Health

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