COVID-19 and pregnancy: A European study on pre- and post-infection medication use

Eimir Hurley, Benjamin P Geisler, Angela Lupattelli, Beatriz Poblador-Plou, Régis Lassalle, Jérémy Jové, Marie-Agnes Bernard, Dunia Sakr, Gabriel Sanfélix-Gimeno, Francisco Sánchez-Saez, Clara L Rodríguez-Bernal, Mònica Sabaté, Elena Ballarín, Cristina Aguilera, Sue Jordan, Daniel Thayer, Ian Farr, Saira Ahmed, Claudia Bartolini, Giorgio LimoncellaOlga Paoletti, Rosa Gini, Luigi A Maglanoc, Elena Dudukina, Vera Ehrenstein, Ema Alsina, Tiago A Vaz, Judit Riera-Arnau, Miriam C J M Sturkenboom, Hedvig M E Nordeng

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Abstract

PURPOSE: The COVID-19 pandemic has impacted medication needs and prescribing practices, including those affecting pregnant women. Our goal was to investigate patterns of medication use among pregnant women with COVID-19, focusing on variations by trimester of infection and location.

METHODS: We conducted an observational study using six electronic healthcare databases from six European regions (Aragon/Spain; France; Norway; Tuscany, Italy; Valencia/Spain; and Wales/UK). The prevalence of primary care prescribing or dispensing was compared in the 30-day periods before and after a positive COVID-19 test or diagnosis.

RESULTS: The study included 294,126 pregnant women, of whom 8943 (3.0%) tested positive for, or were diagnosed with, COVID-19 during their pregnancy. A significantly higher use of antithrombotic medications was observed particularly after COVID-19 infection in the second and third trimesters. The highest increase was observed in the Valencia region where use of antithrombotic medications in the third trimester increased from 3.8% before COVID-19 to 61.9% after the infection. Increases in other countries were lower; for example, in Norway, the prevalence of antithrombotic medication use changed from around 1-2% before to around 6% after COVID-19 in the third trimester. Smaller and less consistent increases were observed in the use of other drug classes, such as antimicrobials and systemic corticosteroids.

CONCLUSION: Our findings highlight the substantial impact of COVID-19 on primary care medication use among pregnant women, with a marked increase in the use of antithrombotic medications post-COVID-19. These results underscore the need for further research to understand the broader implications of these patterns on maternal and neonatal/fetal health outcomes.

Original languageEnglish
Pages (from-to)707-716
Number of pages10
JournalEuropean Journal of Clinical Pharmacology
Volume80
Issue number5
Early online date12 Feb 2024
DOIs
Publication statusPublished - May 2024

Keywords

  • Anti-bacterial agents
  • Antithrombotic medications
  • Antiviral agents
  • COVID-19
  • Drug utilization study
  • Pregnancy
  • Steroids

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