{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:56:14Z","timestamp":1793084174845,"version":"4.5.0"},"reference-count":79,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Canadian Institutes of Health Research (CIHR) \u2013 CAN-AIM","award":["grant number 132750"],"award-info":[{"award-number":["grant number 132750"]}]},{"name":"Fonds de la recherche du Qu\u00e9bec \u2013 Sant\u00e9 (FRQS) - R\u00e9seau de recherche sur les m\u00e9dicaments","award":["grant number 30962"],"award-info":[{"award-number":["grant number 30962"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Medications already available to treat other conditions are presently being studied in clinical trials as potential treatments for COVID-19. Given that pregnant women are excluded from these trials, we aimed to investigate their safety when used during pregnancy within a unique population source.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Using the population-based Quebec Pregnancy Cohort, we identified women who delivered a singleton liveborn (1998\u20132015). Taking potential confounders into account including indications for use, the risk of prematurity, low birth weight (LBW), small for gestational age (SGA), and major congenital malformation (MCM) associated with COVID-19 repurposed drug use during pregnancy were quantified using generalized estimation equations.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 231,075 eligible pregnancies, 107 were exposed to dexamethasone (0.05%), 31 to interferons (0.01%), 1,398 to heparins (0.60%), 24 to angiotensin-receptor blockers (ARB) (0.01%), 182 to chloroquine (0.08%), 103 to hydroxychloroquine (0.05%), 6,206 to azithromycin (2.70%), 230 to oseltamivir (0.10%), and 114 to HIV medications (0.05%). Adjusting for potential confounders, we observed an increased risk of prematurity related to dexamethasone (aOR 1.92, 95%CI 1.11\u20133.33; 15 exposed cases), anti-thrombotics (aOR 1.58, 95%CI 1.31\u20131.91; 177 exposed cases), and HIV medications (aOR 2.04, 95%CI 1.01\u20134.11; 20 exposed cases) use. An increased risk for LBW associated with anti-thrombotics (aOR 1.72, 95%CI 1.41\u20132.11; 152 exposed cases), and HIV medications (aOR 2.48, 95%CI 1.25\u20134.90; 21 exposed cases) use were also found. Gestational exposure to anti-thrombotics (aOR 1.20, 95%CI 1.00\u20131.44; 176 exposed cases), and HIV medications (aOR 2.61, 95%CI 1.51\u20134.51; 30 exposed cases) were associated with SGA. First-trimester dexamethasone (aOR 1.66, 95%CI 1.02\u20132.69; 20 exposed cases) and azithromycin (aOR 1.10, 95%CI 1.02\u20131.19; 747 exposed cases) exposures were associated with MCM.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Many available medications considered as treatments for COVID-19 are associated with adverse pregnancy outcomes. Caution is warranted when considering these medications during the gestational period.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0251746","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T17:42:36Z","timestamp":1621446156000},"page":"e0251746","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7535-5517","authenticated-orcid":true,"given":"Anick","family":"B\u00e9rard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odile","family":"Sheehy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Ping","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyne","family":"Vinet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Quach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behrouz","family":"Kassai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"Bernatsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"pone.0251746.ref001","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1111\/j.1600-0897.2010.00836.x","article-title":"The immune system in pregnancy: a unique complexity","volume":"63","author":"G Mor","year":"2010","journal-title":"Am J Reprod Immunol"},{"key":"pone.0251746.ref002","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/S0889-8545(05)70217-5","article-title":"Pneumonia in pregnancy","volume":"28","author":"PS Ramsey","year":"2001","journal-title":"Obstet Gynecol Clin North Am"},{"key":"pone.0251746.ref003","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1016\/j.ajog.2011.01.048","article-title":"Preparing for influenza after 2009 H1N1: special considerations for pregnant women and newborns","volume":"204","author":"SA Rasmussen","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"pone.0251746.ref004","doi-asserted-by":"crossref","first-page":"769","DOI":"10.15585\/mmwr.mm6925a1","article-title":"Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status\u2014United States, January 22-June 7, 2020","volume":"69","author":"S Ellington","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pone.0251746.ref005","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1002\/uog.23107","article-title":"Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection","volume":"57","author":"COVID WWGo","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"key":"pone.0251746.ref006","unstructured":"https:\/\/clinicaltrials.gov\/ct2\/who_table."},{"key":"pone.0251746.ref007","article-title":"Effect of dexamethasone in hospitalized patients with COVID-19: preliminary report","author":"P Horby","year":"2020","journal-title":"medRxiv"},{"key":"pone.0251746.ref008","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.chom.2020.04.009","article-title":"Complex Immune Dysregulation in COVID-19 Patients with Severe Respiratory Failure","volume":"27","author":"EJ Giamarellos-Bourboulis","year":"2020","journal-title":"Cell Host Microbe"},{"key":"pone.0251746.ref009","doi-asserted-by":"crossref","first-page":"m2648","DOI":"10.1136\/bmj.m2648","article-title":"Dexamethasone in the management of covid -19","volume":"370","author":"RM Johnson","year":"2020","journal-title":"BMJ"},{"key":"pone.0251746.ref010","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.dsx.2020.06.054","article-title":"Role of corticosteroid in the management of COVID-19: A systemic review and a Clinician\u2019s perspective","volume":"14","author":"AK Singh","year":"2020","journal-title":"Diabetes Metab Syndr"},{"key":"pone.0251746.ref011","doi-asserted-by":"crossref","first-page":"198070","DOI":"10.1016\/j.virusres.2020.198070","article-title":"COVID-19: Review on latest available drugs and therapies against SARS-CoV-2. 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