open access publication

Article, Early Access, 2024

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

EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, ISSN 0031-6970, 0031-6970, 10.1007/s00228-024-03639-z


Hurley, Eimir [1] Geisler, Benjamin P. [1] [2] [3] [4] Lupattelli, Angela [1] Poblador-Plou, Beatriz [5] [6] Lassalle, Regis [7] Jove, Jeremy [7] Bernard, Marie-Agnes [7] Sakr, Dunia [7] Sanfelix-Gimeno, Gabriel [8] Sanchez-Saez, Francisco [8] Rodriguez-Bernal, Clara L. [8] Sabate, Monica [9] [10] [11] Ballarin, Elena [9] [10] [11] Aguilera, Cristina [9] [10] [11] Jordan, Sue [12] Thayer, Daniel [12] Farr, Ian [12] Ahmed, Saira [12] Bartolini, Claudia [13] Limoncella, Giorgio [13] Paoletti, Olga [13] Gini, Rosa [13] Maglanoc, Luigi A. [1] Dudukina, Elena [14] Ehrenstein, Vera [14] Alsina, Ema [15] [16] Vaz, Tiago A. [15] [16] Riera-Arnau, Judit [9] [10] [11] [15] [16] Sturkenboom, Miriam C. J. M. [15] [16] Nordeng, Hedvig M. E. (Corresponding author) [1] [17]


  1. [1] Univ Oslo, Fac Math & Nat Sci, Dept Pharm, Pharma epidemiol & Drug Safety Res Grp, Oslo, Norway
  2. [NORA names: Norway; Europe, Non-EU; Nordic; OECD];
  3. [2] Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA USA
  4. [NORA names: United States; America, North; OECD];
  5. [3] Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA USA
  6. [NORA names: United States; America, North; OECD];
  7. [4] Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA USA
  8. [NORA names: United States; America, North; OECD];
  9. [5] Inst Hlth Carlos III, Res Network Hlth Serv Chron Dis, Network Res Chron Primary Care & Hlth Promot, Madrid, Spain
  10. [NORA names: Spain; Europe, EU; OECD];


PurposeThe 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.MethodsWe 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.ResultsThe 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.ConclusionOur 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.


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

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