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Pregnancy and lactation

Session: Poster Session B

(288) Patterns of Prescribed and Dispensed Medicines among Non-Hospitalized Pregnant women with COVID-19: a Prospective Meta-analysis pooling findings from Healthcare Databases in Europe and North America

Tuesday, August 27, 2024
8:00 AM – 6:00 PM CEST
Location: Convention Hall II

    Presenting Author(s)

  • Odette de Bruin, MD (she/her/hers)

    PhD student
    Department of Obstetrics, Division Woman and Baby, Wilhelmina Children’s Hospital, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands, Netherlands

    • Co-Author(s)

  • Emeline Maisonneuve, MD (she/her/hers)

    PhD student
    Institute of Primary Health Care (BIHAM)
    Bern, Switzerland

  • EH

    Eimir Hurley

    Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, University Oslo (UiO), Oslo, Norway, Norway

  • Hedvig M.E Nordeng, PhD (she/her/hers)

    Professor
    Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo (UiO), Oslo, Norway
    Oslo, Norway

  • Anick Bérard, PhD, FCAHS, FISPE (she/her/hers)

    Professor
    Université de Montréal
    Montreal, Canada

  • Odile Sheehy, MSc (she/her/hers)

    Senior Biostatisitician
    Centre Hospitalier Universitaire (CHU) de Sainte-Justine, Montreal, Quebec, Canada
    Saint-Laurent, Canada

  • PK

    Padma Kaul

    University of Alberta, Edmonton, Alberta, Canada, Canada

  • MS

    Mayura Shinde, DrPH

    Research Scientist
    Harvard Pilgrim Health Care Institute, United States

  • AC

    Austin Cosgrove

    Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA, United States

  • JL

    Jennifer G. Lyons

    Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA, United States

  • EM

    Elizabeth Messenger-Jones

    Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA, United States

  • MK

    Maria E. Kempner

    Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA, United States

  • DT

    Darren Toh, ScD

    Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA, United States

  • WH

    Wei Hua, MSc, MHS, MD, PhD

    Deputy Division Director
    Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, USA, United States

  • José J. Hernández-Muñoz, RPh, MPH, MSc, PhD

    Pharmacoepidemiologist
    Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, USA
    The Woodlands, United States

  • Leyla Sahin, MD

    Deputy Director for Safety
    Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, USA
    Silver Spring, United States

  • Carolyn E. Cesta, PhD

    Assistant Professor
    Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden.
    Stockholm, Sweden

  • DH

    David Hägg, PhD

    Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden, Sweden

  • Rosa Gini, PhD (she/her/hers)

    Head of Unit at ARS Toscana, Florence, Italy
    ARS Toscana, Florence, Italy
    Florence, Italy

  • OP

    Olga Paoletti

    Researcher
    ARS Toscana, Italy

  • BP

    Beatriz Poblador-Plou

    EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain, Spain

  • SJ

    Sue Jordan, MB.BCh., PhD. PGCE (FE),

    professor
    Faculty of Medicine, Health and Life Science, Swansea University, Wales, UK, United Kingdom

  • DT

    Daniel Thayer

    Faculty of Medicine, Health and Life Science, Swansea University, Wales, UK, United Kingdom

  • Clara L. Rodríguez-Bernal, DDS, PhD

    Lead of perinatal pharmacoepidemiology research
    Health Services Research and Pharmacoepidemiology Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Valencia, Spain, Spain

  • FS

    Francisco Sánchez-Sáez

    Health Services Research and Pharmacoepidemiology Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Valencia, Spain, Spain

  • RL

    Régis Lassalle, MSc

    Head of Statistics and Data management
    Bordeaux PharmacoEpi, INSERM CIC-P1401, Université de Bordeaux, Bordeaux, France
    Bordeaux, France

  • MB

    Marie-Agnès Bernard

    Statistician
    Bordeaux PharmacoEpi, INSERM CIC-P1401, Université de Bordeaux, Bordeaux, France, France

  • EA

    Ema Alsina

    Department of Data Science & Biostatistics, Julius Global Health, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands, Netherlands

  • Fariba Ahmadizar, PharmD, MSc, PhD (she/her/hers)

    Assistant Professor
    Department of Data Science & Biostatistics, Julius Global Health, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands, Netherlands

  • GF

    Guillaume Favre

    Materno-Fetal and Obstetrics Research Unit, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland, Switzerland

  • AP

    Alice Panchaud

    Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Service of Pharmacy, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland, Switzerland

  • KB

    Kitty W.M. Bloemenkamp

    Department of Obstetrics, Wilhelmina Children’s Hospital, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands, Netherlands

  • Kelly Plueschke, PharmD

    Senior Scientific Administrator, Real World Evidence workstream
    European Medicines Agency
    Amsterdam, Netherlands

  • Cd

    Corinne de Vries

    European Medicines Agency, Netherlands

  • SS

    Satu J. Siiskonen

    Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands, Netherlands

  • Miriam C.J.M. Sturkenboom, PhD

    Professor
    Department of Data Science & Biostatistics, Julius Global Health, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
    Utrecht, Netherlands

Background: There is a significant void in our understanding of the specific medications utilized by pregnant women with COVID-19 in real-world outpatient settings. Existing evidence refers to small populations or inpatient prescriptions only.

Objectives: To estimate medication use prevalence by pregnancy trimester in non-hospitalized pregnant women with COVID-19 and compare it with pregnant women without COVID-19 and non-pregnant women with COVID-19.

Methods: A prospective meta-analysis as part of the CONSIGN project was conducted, pooling results from 11 healthcare databases in Europe (CONSIGN EHR study), the USA (Sentinel system), and Canada (CAMCCO). Prescribed or dispensed medications within 30-days pre- and post-COVID-19 diagnosis were identified between 2020 to 2022 among non-hospitalized pregnant women with COVID-19. Comparisons were made between the prevalence pre- and post-COVID-19 diagnosis in this cohort and two comparator groups: i) pregnant women without COVID-19, and ii) non-pregnant women with COVID-19. Prevalence estimates were pooled using a random-effects model for meta-analysis of proportions and stratified by trimester.

Results: A cohort of 50,335 non-hospitalized pregnant women with COVID-19 were identified of whom half had an infection in the 3rd trimester (50.6%). Among these 3rd trimester pregnancies, the pooled prevalence of antibacterial use was significantly higher post-COVID-19 diagnosis (6.8%, 95%CI 5.5-8.4, I2=94%) compared with pre-COVID-19 diagnosis (3.9%, 95%CI 3.1-4.9, I2=89%). Although pregnant women with COVID-19 had higher medication use than pregnant women without COVID-19, these differences were not statistically significant. Post-COVID-19, antithrombotics pooled prevalence rose to 4.5% (95%CI 1.1-16.5, I2=100%) among pregnant women with COVID-19 in the 3rd trimester versus 2.1% (95%CI 1.2-3.6, I2=99%) in pregnant women without COVID-19. Pregnant women with COVID-19 were less likely to be prescribed analgesics, corticosteroids, and psychoanaleptics, and more likely to be prescribed antithrombotics and drugs used in diabetes across all trimesters compared with non-pregnant women with COVID-19 in the 30-days post diagnosis. The pooled prevalence of antithrombotics post-COVID-19 among pregnant women in 3rd trimester was 5.2% (95%CI 1.2-20.6, I2=100%), compared with 0.7% (95%CI 0.3-1.4, I2=99%) in non-pregnant women. High heterogeneity existed in nearly all analyses.

Conclusions: 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.