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Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America

Odette de Bruin Orcid Logo, Emeline Maisonneuve Orcid Logo, Eimir Hurley Orcid Logo, Hedvig M E Nordeng Orcid Logo, Anick Bérard Orcid Logo, Odile Sheehy Orcid Logo, Padma Kaul Orcid Logo, Mayura U Shinde, Austin Cosgrove, Jennifer G Lyons, Elizabeth Messenger-Jones, Maria E Kempner, Sengwee Toh, Wei Hua, José J Hernández-Muñoz Orcid Logo, Leyla Sahin Orcid Logo, Carolyn E Cesta Orcid Logo, David Hägg Orcid Logo, Rosa Gini Orcid Logo, Olga Paoletti, Beatriz Poblador-Plou, Sue Jordan, Daniel Thayer Orcid Logo, Clara L Rodríguez-Bernal Orcid Logo, Francisco Sánchez-Sáez, Régis Lassalle, Marie-Agnès Bernard, Ema Alsina, Fariba Ahmadizar, Guillaume Favre Orcid Logo, Alice Panchaud Orcid Logo, Kitty W M Bloemenkamp Orcid Logo, Kelly Plueschke, Corinne de Vries, Satu J Siiskonen Orcid Logo, Miriam C J M Sturkenboom Orcid Logo

Pharmacoepidemiology and Drug Safety, Volume: 35, Issue: 1, Start page: e70303

Swansea University Authors: Sue Jordan, Daniel Thayer Orcid Logo

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DOI (Published version): 10.1002/pds.70303

Abstract

To estimate the prevalence of medication use in nonhospitalized pregnant women with COVID-19. 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...

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Published in: Pharmacoepidemiology and Drug Safety
ISSN: 1053-8569 1099-1557
Published: Wiley 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71206
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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&#x2009;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. 50&#x2009;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]&#x2009;=&#x2009;5.5-8.4, I &#x2009;=&#x2009;94%) compared with the same women pre-COVID-19 (3.9%, 95% CI&#x2009;=&#x2009;3.1-4.9, I &#x2009;=&#x2009;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&#x2009;=&#x2009;1.1-16.5, I &#x2009;=&#x2009;100%) among pregnant women with COVID-19 in the third trimester, compared to 2.1% (95% CI&#x2009;=&#x2009;1.2-3.6, I &#x2009;=&#x2009;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. 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.</abstract><type>Journal Article</type><journal>Pharmacoepidemiology and Drug Safety</journal><volume>35</volume><journalNumber>1</journalNumber><paginationStart>e70303</paginationStart><paginationEnd/><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1053-8569</issnPrint><issnElectronic>1099-1557</issnElectronic><keywords>CONSIGN, COVID-19, medication use, meta-analysis, pregnancy</keywords><publishedDay>1</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2026</publishedYear><publishedDate>2026-01-01</publishedDate><doi>10.1002/pds.70303</doi><url/><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>European Medicines Agency (EMA). Grant Number: EMA/2018/28/PE; Canadian Institutes of Health Research (CIHR); Canada Foundation for Innovation (CFI); U.S. Food and Drug Administration (FDA)</funders><projectreference/><lastEdited>2026-01-08T09:33:36.4600581</lastEdited><Created>2026-01-08T09:24:40.9130144</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Nursing</level></path><authors><author><firstname>Odette de</firstname><surname>Bruin</surname><orcid>0000-0001-6295-3411</orcid><order>1</order></author><author><firstname>Emeline</firstname><surname>Maisonneuve</surname><orcid>0000-0001-5765-4468</orcid><order>2</order></author><author><firstname>Eimir</firstname><surname>Hurley</surname><orcid>0000-0001-6776-1224</orcid><order>3</order></author><author><firstname>Hedvig M E</firstname><surname>Nordeng</surname><orcid>0000-0001-6361-2918</orcid><order>4</order></author><author><firstname>Anick</firstname><surname>B&#xE9;rard</surname><orcid>0000-0001-7535-5517</orcid><order>5</order></author><author><firstname>Odile</firstname><surname>Sheehy</surname><orcid>0000-0002-6784-2080</orcid><order>6</order></author><author><firstname>Padma</firstname><surname>Kaul</surname><orcid>0000-0003-2239-3944</orcid><order>7</order></author><author><firstname>Mayura U</firstname><surname>Shinde</surname><order>8</order></author><author><firstname>Austin</firstname><surname>Cosgrove</surname><order>9</order></author><author><firstname>Jennifer G</firstname><surname>Lyons</surname><order>10</order></author><author><firstname>Elizabeth</firstname><surname>Messenger-Jones</surname><order>11</order></author><author><firstname>Maria E</firstname><surname>Kempner</surname><order>12</order></author><author><firstname>Sengwee</firstname><surname>Toh</surname><order>13</order></author><author><firstname>Wei</firstname><surname>Hua</surname><order>14</order></author><author><firstname>Jos&#xE9; J</firstname><surname>Hern&#xE1;ndez-Mu&#xF1;oz</surname><orcid>0000-0002-2553-3159</orcid><order>15</order></author><author><firstname>Leyla</firstname><surname>Sahin</surname><orcid>0000-0002-7685-7524</orcid><order>16</order></author><author><firstname>Carolyn E</firstname><surname>Cesta</surname><orcid>0000-0001-5759-9366</orcid><order>17</order></author><author><firstname>David</firstname><surname>H&#xE4;gg</surname><orcid>0000-0002-2610-5033</orcid><order>18</order></author><author><firstname>Rosa</firstname><surname>Gini</surname><orcid>0000-0002-6250-877X</orcid><order>19</order></author><author><firstname>Olga</firstname><surname>Paoletti</surname><order>20</order></author><author><firstname>Beatriz</firstname><surname>Poblador-Plou</surname><order>21</order></author><author><firstname>Sue</firstname><surname>Jordan</surname><order>22</order></author><author><firstname>Daniel</firstname><surname>Thayer</surname><orcid>0000-0003-1847-4362</orcid><order>23</order></author><author><firstname>Clara L</firstname><surname>Rodr&#xED;guez-Bernal</surname><orcid>0000-0003-2617-8635</orcid><order>24</order></author><author><firstname>Francisco</firstname><surname>S&#xE1;nchez-S&#xE1;ez</surname><order>25</order></author><author><firstname>R&#xE9;gis</firstname><surname>Lassalle</surname><order>26</order></author><author><firstname>Marie-Agn&#xE8;s</firstname><surname>Bernard</surname><order>27</order></author><author><firstname>Ema</firstname><surname>Alsina</surname><order>28</order></author><author><firstname>Fariba</firstname><surname>Ahmadizar</surname><order>29</order></author><author><firstname>Guillaume</firstname><surname>Favre</surname><orcid>0000-0001-6181-3126</orcid><order>30</order></author><author><firstname>Alice</firstname><surname>Panchaud</surname><orcid>0000-0001-6086-2401</orcid><order>31</order></author><author><firstname>Kitty W M</firstname><surname>Bloemenkamp</surname><orcid>0000-0002-1377-4625</orcid><order>32</order></author><author><firstname>Kelly</firstname><surname>Plueschke</surname><order>33</order></author><author><firstname>Corinne de</firstname><surname>Vries</surname><order>34</order></author><author><firstname>Satu J</firstname><surname>Siiskonen</surname><orcid>0000-0003-3095-9530</orcid><order>35</order></author><author><firstname>Miriam C J M</firstname><surname>Sturkenboom</surname><orcid>0000-0003-1360-2388</orcid><order>36</order></author></authors><documents><document><filename>71206__35917__9bbb9897ba524f25b8f99e199c8ebd2b.pdf</filename><originalFilename>71206.VOR.pdf</originalFilename><uploaded>2026-01-08T09:31:01.1235120</uploaded><type>Output</type><contentLength>4635329</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2025 The Author(s). 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spelling 2026-01-08T09:33:36.4600581 v2 71206 2026-01-08 Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America 24ce9db29b4bde1af4e83b388aae0ea1 Sue Jordan Sue Jordan true false e1a6d9b30965cc61a76371fc8a1bf232 0000-0003-1847-4362 Daniel Thayer Daniel Thayer true false 2026-01-08 To estimate the prevalence of medication use in nonhospitalized pregnant women with COVID-19. 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. 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, I  = 94%) compared with the same women pre-COVID-19 (3.9%, 95% CI = 3.1-4.9, I  = 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, I  = 100%) among pregnant women with COVID-19 in the third trimester, compared to 2.1% (95% CI = 1.2-3.6, I  = 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. 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. Journal Article Pharmacoepidemiology and Drug Safety 35 1 e70303 Wiley 1053-8569 1099-1557 CONSIGN, COVID-19, medication use, meta-analysis, pregnancy 1 1 2026 2026-01-01 10.1002/pds.70303 COLLEGE NANME COLLEGE CODE Swansea University Another institution paid the OA fee European Medicines Agency (EMA). Grant Number: EMA/2018/28/PE; Canadian Institutes of Health Research (CIHR); Canada Foundation for Innovation (CFI); U.S. Food and Drug Administration (FDA) 2026-01-08T09:33:36.4600581 2026-01-08T09:24:40.9130144 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Odette de Bruin 0000-0001-6295-3411 1 Emeline Maisonneuve 0000-0001-5765-4468 2 Eimir Hurley 0000-0001-6776-1224 3 Hedvig M E Nordeng 0000-0001-6361-2918 4 Anick Bérard 0000-0001-7535-5517 5 Odile Sheehy 0000-0002-6784-2080 6 Padma Kaul 0000-0003-2239-3944 7 Mayura U Shinde 8 Austin Cosgrove 9 Jennifer G Lyons 10 Elizabeth Messenger-Jones 11 Maria E Kempner 12 Sengwee Toh 13 Wei Hua 14 José J Hernández-Muñoz 0000-0002-2553-3159 15 Leyla Sahin 0000-0002-7685-7524 16 Carolyn E Cesta 0000-0001-5759-9366 17 David Hägg 0000-0002-2610-5033 18 Rosa Gini 0000-0002-6250-877X 19 Olga Paoletti 20 Beatriz Poblador-Plou 21 Sue Jordan 22 Daniel Thayer 0000-0003-1847-4362 23 Clara L Rodríguez-Bernal 0000-0003-2617-8635 24 Francisco Sánchez-Sáez 25 Régis Lassalle 26 Marie-Agnès Bernard 27 Ema Alsina 28 Fariba Ahmadizar 29 Guillaume Favre 0000-0001-6181-3126 30 Alice Panchaud 0000-0001-6086-2401 31 Kitty W M Bloemenkamp 0000-0002-1377-4625 32 Kelly Plueschke 33 Corinne de Vries 34 Satu J Siiskonen 0000-0003-3095-9530 35 Miriam C J M Sturkenboom 0000-0003-1360-2388 36 71206__35917__9bbb9897ba524f25b8f99e199c8ebd2b.pdf 71206.VOR.pdf 2026-01-08T09:31:01.1235120 Output 4635329 application/pdf Version of Record true © 2025 The Author(s). This is an open access article under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America
spellingShingle Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America
Sue Jordan
Daniel Thayer
title_short Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America
title_full Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America
title_fullStr Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America
title_full_unstemmed Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America
title_sort Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America
author_id_str_mv 24ce9db29b4bde1af4e83b388aae0ea1
e1a6d9b30965cc61a76371fc8a1bf232
author_id_fullname_str_mv 24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
e1a6d9b30965cc61a76371fc8a1bf232_***_Daniel Thayer
author Sue Jordan
Daniel Thayer
author2 Odette de Bruin
Emeline Maisonneuve
Eimir Hurley
Hedvig M E Nordeng
Anick Bérard
Odile Sheehy
Padma Kaul
Mayura U Shinde
Austin Cosgrove
Jennifer G Lyons
Elizabeth Messenger-Jones
Maria E Kempner
Sengwee Toh
Wei Hua
José J Hernández-Muñoz
Leyla Sahin
Carolyn E Cesta
David Hägg
Rosa Gini
Olga Paoletti
Beatriz Poblador-Plou
Sue Jordan
Daniel Thayer
Clara L Rodríguez-Bernal
Francisco Sánchez-Sáez
Régis Lassalle
Marie-Agnès Bernard
Ema Alsina
Fariba Ahmadizar
Guillaume Favre
Alice Panchaud
Kitty W M Bloemenkamp
Kelly Plueschke
Corinne de Vries
Satu J Siiskonen
Miriam C J M Sturkenboom
format Journal article
container_title Pharmacoepidemiology and Drug Safety
container_volume 35
container_issue 1
container_start_page e70303
publishDate 2026
institution Swansea University
issn 1053-8569
1099-1557
doi_str_mv 10.1002/pds.70303
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
document_store_str 1
active_str 0
description To estimate the prevalence of medication use in nonhospitalized pregnant women with COVID-19. 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. 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, I  = 94%) compared with the same women pre-COVID-19 (3.9%, 95% CI = 3.1-4.9, I  = 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, I  = 100%) among pregnant women with COVID-19 in the third trimester, compared to 2.1% (95% CI = 1.2-3.6, I  = 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. 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.
published_date 2026-01-01T05:34:42Z
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score 11.096212

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