Medications used among Non-Hospitalized Pregnant Women with COVID-19: a Prospective Individual Patient Data Meta-analysis in Europe and North America

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Aim To estimate the prevalence of medication use in non-hospitalized 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 non-hospitalized pregnant women with COVID-19 between January 2020 to 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 non-pregnant women with COVID-19. Prevalence estimates were pooled using a random-effects model stratified by trimester. Results 50,335 non-hospitalized pregnant women with COVID-19 were identified. The pooled prevalence of antibacterial use in 3 rd trimester was higher post-COVID-19 diagnosis (6.8%, 95%CI 5.5-8.4, I 2 =94%) compared with the same women pre-COVID-19 (3.9%, 95%CI 3.1-4.9, I 2 =89%). Overall, pregnant women with COVID-19 had higher medication use compared to pregnant women without COVID-19, although these differences were not statistically significant. Post-COVID-19, antithrombotics prevalence was 4.5% (95%CI 1.1-16.5, I 2 =100%) among pregnant women with COVID-19 in 3 rd trimester, compared to 2.1% (95%CI 1.2-3.6, I 2 =99%) among those without COVID-19 in 3 rd trimester. Compared to non-pregnant 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 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 non-hospitalized pregnant women. Higher antithrombotics use post-COVID-19 suggests prophylactic treatment in this population.