Maisonneuve Emeline, De Bruin Odette, Favre Guillaume, Oakley Erin, Kim Jenny Yeon Hee, Farooq Fouzia, Al-Fadel Nouf, Almutairi Abdulaali, Del Mar Gil Maria, Fernandez Buhigas Irene, Visentin Silvia, Cosmi Erich, Surita Fernanda, Souza Renato T, Cecatti José G, Costa Maria Laura, Sanin-Blair Jose, Tolosa Jorge E, Hadar Eran, Goncé Anna, Poncelet Christophe, Forestier Fabienne, Quibel Thibaud, Martinez de Tejada Begoña, Eggel-Hort Béatrice, Capoccia Brugger Romina, Surbek Daniel, Raio Luigi, Radan Anda-Petronela, Todesco-Bernasconi Monya, Monod Cécile, Schäffer Leonard, Harnadi Anett, Mousavi Sayed Hamid, Ayres-de-Campos Diogo, Pomar Léo, Sichitiu Joanna, Salomon Laurent J, Ville Yves, Papadia Andrea, Rossier Marie-Claude, Schuler-Faccini Lavinia, Goncalves Pereira Natalya, Etchegaray Adolfo, Nieto-Calvache Albaro Jose, Geary Michael, Fuenzalida Javiera, Grawe Claudia, Ko Albert I, Johann Silke, De Santis Marco, Voekt Cora Alexandra, Hcini Najeh, Nielsen-Saines Karin, Garabedian Charles, Sentilhes Loïc, May Feuerschuette Otto H, Vetter Grit, Wardhana Manggala Pasca, Dajti Irida, Bloemenkamp Kitty W M, Siiskonen Satu J, Smith Emily R, Baud David, Panchaud Alice, Sturkenboom Miriam C J M
Materno-Fetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant", University Hospital, Lausanne, Switzerland.
Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Pharmacoepidemiol Drug Saf. 2025 Jul;34(7):e70180. doi: 10.1002/pds.70180.
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.
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.
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.
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.
通过估计孕期用于治疗新冠病毒病（COVID-19）的药物使用 prevalence，按住院情况、妊娠 trimester 和国家进行分层，描述对 COVID-19 大流行的国际应对情况。
我们对孕期用于治疗 COVID-19 的药物的原始数据中的比例进行了两阶段个体参与者数据荟萃分析。开发了一个通用数据模型来汇总来自单国家和国际登记处的数据。2020 年 2 月至 2022 年 10 月期间感染 COVID-19 的孕妇的数据被纳入 9 个数据源的研究平台。患者信息从医疗记录中提取。
在 24937 名孕妇中，接受治疗 COVID-19 药物的个体的汇总 prevalence 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 0.8%、康复血浆 0.3%、免疫抑制剂 0.2%、单克隆抗体 0.02%。住院个体的药物使用 prevalence 高于非住院个体：肝素分别为 58.4% 和 17.9%，抗生素分别为 26.9% 和 5.7%，皮质类固醇分别为 17.5% 和 1.3%，抗病毒药物分别为 10.3% 和 0.3%，抗疟药分别为 4.5% 和 0.1%。与妊娠第二（7.2%）和第三（4.9%）trimester 相比，妊娠第一 trimester 皮质类固醇的使用 prevalence 较低（0.1%）。各国之间药物的使用 prevalence 差异很大。
用于治疗 COVID-19 的药物在因 COVID-19 住院的孕妇中使用更为频繁。妊娠第一 trimester 使用皮质类固醇较少。各国之间的使用差异可能反映了该重症风险人群在临床管理和药物获取方面的差异。
