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

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2025-07-01 DOI:10.1002/pds.70180

Emeline Maisonneuve, Odette De Bruin, Guillaume Favre, Erin Oakley, Jenny Yeon Hee Kim, Fouzia Farooq, Nouf Al-Fadel, Abdulaali Almutairi, Maria Del Mar Gil, Irene Fernandez Buhigas, Silvia Visentin, Erich Cosmi, Fernanda Surita, Renato T Souza, José G Cecatti, Maria Laura Costa, Jose Sanin-Blair, Jorge E Tolosa, Eran Hadar, Anna Goncé, Christophe Poncelet, Fabienne Forestier, Thibaud Quibel, Begoña Martinez de Tejada, Béatrice Eggel-Hort, Romina Capoccia Brugger, Daniel Surbek, Luigi Raio, Anda-Petronela Radan, Monya Todesco-Bernasconi, Cécile Monod, Leonard Schäffer, Anett Harnadi, Sayed Hamid Mousavi, Diogo Ayres-de-Campos, Léo Pomar, Joanna Sichitiu, Laurent J Salomon, Yves Ville, Andrea Papadia, Marie-Claude Rossier, Lavinia Schuler-Faccini, Natalya Goncalves Pereira, Adolfo Etchegaray, Albaro Jose Nieto-Calvache, Michael Geary, Javiera Fuenzalida, Claudia Grawe, Albert I Ko, Silke Johann, Marco De Santis, Cora Alexandra Voekt, Najeh Hcini, Karin Nielsen-Saines, Charles Garabedian, Loïc Sentilhes, Otto H May Feuerschuette, Grit Vetter, Manggala Pasca Wardhana, Irida Dajti, Kitty W M Bloemenkamp, Satu J Siiskonen, Emily R Smith, David Baud, Alice Panchaud, Miriam C J M Sturkenboom

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引用次数: 0

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.

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COVID-19妊娠期治疗如何反映大流行期间的医疗保健利用：结合基于病例登记的两阶段个体参与者数据荟萃分析

目的：通过估计妊娠期COVID-19治疗药物使用的流行情况，并按住院、妊娠三个月和国家分层，描述对COVID-19大流行的国际反应。方法：我们对妊娠期间用于治疗COVID-19的药物的主要数据进行了两阶段的个体参与者数据荟萃分析。开发了一个通用的数据模型，以便汇集来自单一国家和国际登记的数据。2020年2月至2022年10月期间感染COVID-19孕妇的数据被纳入9个数据源的研究平台。患者信息是从病历中提取出来的。结果：24937例孕妇中，接受药物治疗的总患病率为：肝素34.7%、抗生素9.8%、皮质类固醇4.9%、抗病毒药物2.2%、抗疟药物0.8%、恢复期血浆0.3%、免疫抑制剂0.2%、单克隆抗体0.02%。住院患者的药物使用率高于非住院患者：肝素组58.4%比17.9%，抗生素组26.9%比5.7%，皮质类固醇组17.5%比1.3%，抗病毒药物组10.3%比0.3%，抗疟药物组4.5%比0.1%。与妊娠中期（7.2%）和妊娠晚期（4.9%）相比，妊娠早期（0.1%）皮质类固醇的使用率较低。各国药物的流行程度差别很大。结论：在因COVID-19住院的孕妇中，使用药物治疗的频率更高。在怀孕的前三个月，皮质类固醇的使用较少。各国之间使用的差异可能反映了这一有严重疾病风险的人群在临床管理和获得药物方面的差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.