{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:09:16Z","timestamp":1763644156077,"version":"build-2065373602"},"reference-count":49,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III (ISCIII)","award":["PI21\/00907"],"award-info":[{"award-number":["PI21\/00907"]}]},{"name":"European Union","award":["PI21\/00907"],"award-info":[{"award-number":["PI21\/00907"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Although pregnant women were considered a risk population for COVID-19, little is known of their drug use during the pandemic. We aimed to investigate COVID-19 distribution, drug use patterns and COVID-19 medication. We conducted a retrospective cohort of validated pregnancies aged 15\u201349 years, from January 2020 to December 2022, using the BIFAP database. An identified cohort of pregnant women with COVID-19 was matched by age, gestational age, length of pregnancy and outcome to a cohort free of COVID-19 (8413 vs. 24,975). We performed a descriptive analysis on COVID-19 cases, estimated the drug use patterns and assessed COVID-19-specific drugs within the week prior\/after diagnosis, stratified by pandemic wave and gestational week. The results showed that 72% of pregnant women with COVID-19 received at least one prescription vs. 66.6% of those free of COVID-19, with analgesics, antibiotics and thyroid hormones being the most prescribed drugs in both groups. In the COVID-19 group, they were antithrombotics (40 prescriptions per 100 women), analgesic\/NSAIDs (19.64\/6.29) and antibiotics (6.95). COVID-19 cases gradually increased, peaking at the fifth and second waves. Prescription rates were similar when compared to pre-pandemic studies. The use of drugs compatible with COVID-19 treatments was in line with recommendations.<\/jats:p>","DOI":"10.3390\/ph17020207","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T03:22:31Z","timestamp":1707189751000},"page":"207","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["COVID-19 Distribution in Pregnancy, Drug Use Patterns and COVID-19 Medication during the Pandemic in Spain: Data from Real-World Electronic Health Records"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4228-9506","authenticated-orcid":false,"given":"Mercedes","family":"Mota-P\u00e9rez","sequence":"first","affiliation":[{"name":"Department of Public Health and Maternal Child Health, Faculty of Medicine, Complutense University of Madrid, Plaza Ram\u00f3n y Cajal, s\/n. Ciudad Universitaria, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4012-7826","authenticated-orcid":false,"given":"Consuelo","family":"Huerta-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Department of Public Health and Maternal Child Health, Faculty of Medicine, Complutense University of Madrid, Plaza Ram\u00f3n y Cajal, s\/n. Ciudad Universitaria, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Llorente","sequence":"additional","affiliation":[{"name":"Base de datos para la Investigaci\u00f3n Farmacoepidemiol\u00f3gica en el \u00c1mbito P\u00fablico (BIFAP), Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices (AEMPS), 28022 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7051-0730","authenticated-orcid":false,"given":"Luc\u00eda","family":"Cea-Soriano","sequence":"additional","affiliation":[{"name":"Department of Public Health and Maternal Child Health, Faculty of Medicine, Complutense University of Madrid, Plaza Ram\u00f3n y Cajal, s\/n. Ciudad Universitaria, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100107","DOI":"10.1016\/j.ajogmf.2020.100107","article-title":"Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: A systematic review and meta-analysis","volume":"2","author":"Khalil","year":"2020","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E540","DOI":"10.1503\/cmaj.202604","article-title":"The impact of COVID-19 on pregnancy outcomes: A systematic review and meta-analysis","volume":"193","author":"Wei","year":"2021","journal-title":"Can. Med. Assoc. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.cmi.2020.10.007","article-title":"Impact of COVID-19 on maternal and neonatal outcomes: A systematic review and meta-analysis","volume":"27","author":"Gjoka","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.jinf.2020.03.041","article-title":"Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis","volume":"80","author":"Fu","year":"2020","journal-title":"J. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-021-92357-y","article-title":"Maternal outcomes and risk factors for COVID-19 severity among pregnant women","volume":"11","author":"Vouga","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_6","first-page":"1","article-title":"Antenatal care utilization during the COVID-19 pandemic: An online cross-sectional survey among Filipino women","volume":"22","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12978-021-01070-6","article-title":"The impact of the COVID-19 pandemic on maternal and perinatal health: A scoping review","volume":"18","author":"Kotlar","year":"2021","journal-title":"Reprod. Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"49","DOI":"10.13189\/ujph.2018.060203","article-title":"The Factors Associated with the Delayed First Antenatal Care in the Philippines","volume":"6","author":"Horiguchi","year":"2018","journal-title":"Univers. J. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/j.1728-4465.2010.00250.x","article-title":"Unintended Pregnancy: Worldwide Levels, Trends, and Outcomes","volume":"41","author":"Singh","year":"2010","journal-title":"Stud. Fam. Plan."},{"key":"ref_10","first-page":"149","article-title":"Use of prescribed drugs among primiparous women: An 11-year population-based study in Denmark","volume":"3","author":"Norgaard","year":"2011","journal-title":"Clin. Epidemiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Smolina, K., Hanley, G.E., Mintzes, B., Oberlander, T.F., and Morgan, S. (2015). Trends and Determinants of Prescription Drug Use during Pregnancy and Postpartum in British Columbia, 2002\u20132011: A Population-Based Cohort Study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0128312"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Dillon, P., O\u2019brien, K.K., McDonnell, R., Donnelly-Swift, E., Galvin, R., Roche, A., Cronin, K., Walsh, D.R., Schelten, R., and Smith, S. (2015). Prevalence of prescribing in pregnancy using the Irish primary care research network: A pilot study. BMC Pregnancy Childbirth, 15.","DOI":"10.1186\/s12884-015-0489-0"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"51.E1","DOI":"10.1016\/j.ajog.2011.02.029","article-title":"Medication use during pregnancy, with particular focus on prescription drugs: 1976\u20132008","volume":"205","author":"Mitchell","year":"2011","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1002\/pds.2184","article-title":"Prescription drug use during pregnancy in developed countries: A systematic review","volume":"20","author":"Daw","year":"2011","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/AOG.0000000000000982","article-title":"The Most Commonly Dispensed Prescription Medications Among Pregnant Women Enrolled in the U.S. Medicaid Program","volume":"126","author":"Palmsten","year":"2015","journal-title":"Obstet. Gynecol."},{"key":"ref_16","first-page":"1","article-title":"Births: Final data for 2010","volume":"61","author":"Martin","year":"2012","journal-title":"Natl. Vital Stat. Rep."},{"key":"ref_17","unstructured":"Hamilton, B.E., Martin, J.A., and Osterman, M.J.K. (2023, June 24). Vital Statistics Rapid Release Births: Provisional Data for 2020, Available online: https:\/\/www.cdc.gov\/nchs\/products\/index.htm."},{"key":"ref_18","unstructured":"WHO Solidarity Trial Consortium, Pan, H., Peto, R., Abdool Karim, Q., Alejandria, M., Henao-Restrepo, A.M., Hern\u00e1ndez Garc\u00eda, C., Kieny, M.-P., Malekzadeh, R., and Murthy, S. (medRxiv, 2020). Repurposed antiviral drugs for COVID-19\u2014Interim WHO SOLIDARITY trial results, medRxiv."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"The RECOVERY Collaborative Group (2021). Dexamethasone in Hospitalized Patients with COVID-19. New Engl. J. Med., 384, 693\u2013704.","DOI":"10.1056\/NEJMoa2021436"},{"key":"ref_20","unstructured":"Unidad de la Mujer (2023, January 22). Heparina en el Embarazo por Infecci\u00f3n por COVID-19. Available online: https:\/\/www.unidaddelamujer.es\/heparina-en-el-embarazo-por-infeccion-por-covid-19\/."},{"key":"ref_21","unstructured":"Preevid (2023, January 22). Mujer Embarazada con Diagn\u00f3stico de COVID-19, \u00bfSe Podr\u00eda Obviar el Uso de Heparina para la Tromboprofilaxis, si se Confirma que la Cepa es Omicron? [Pregnant Woman Diagnosed with COVID-19, Could the Use of Heparin for Thromboprophylaxis be Avoided, if the Strain is Confirmed to be Omicron?]. Available online: https:\/\/www.murciasalud.es\/preevid\/24541."},{"key":"ref_22","unstructured":"(2023, January 22). Antithrombotic Therapy|COVID-19 Treatment Guidelines, Available online: https:\/\/www.covid19treatmentguidelines.nih.gov\/therapies\/antithrombotic-therapy\/."},{"key":"ref_23","unstructured":"(2023, June 25). Tracking SARS-CoV-2 Variants. Available online: https:\/\/www.who.int\/activities\/tracking-SARS-CoV-2-variants."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"100110","DOI":"10.1016\/j.ajogmf.2020.100110","article-title":"Labor and delivery guidance for COVID-19","volume":"2","author":"Boelig","year":"2020","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-023-05349-3","article-title":"Pregnancy in the time of COVID-19: Towards Fetal monitoring 4.0","volume":"23","author":"Kahankova","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jad.2020.07.126","article-title":"Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic","volume":"277","author":"Lebel","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s00737-020-01073-5","article-title":"Pregnancy-related anxiety during COVID-19: A nationwide survey of 2740 pregnant women","volume":"23","author":"Moyer","year":"2020","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e01835","DOI":"10.1002\/brb3.1835","article-title":"The relationship among fear and anxiety of COVID-19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model","volume":"10","author":"Salehi","year":"2020","journal-title":"Brain Behav."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1002\/pds.4910","article-title":"An algorithm to identify pregnancies in BIFAP Primary Care database in Spain: Results from a cohort of 155,419 pregnancies","volume":"29","author":"Ortiz","year":"2020","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/pds.1269","article-title":"Safety of medications prescribed before and during early pregnancy in a cohort of 81,975 mothers from the UK General Practice Research Database","volume":"15","author":"Hardy","year":"2006","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1002\/pds.3472","article-title":"Challenges of using primary care electronic medical records in the UK to study medications in pregnancy","volume":"22","author":"Cantero","year":"2013","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s00228-017-2398-9","article-title":"The limitations of some European healthcare databases for monitoring the effectiveness of pregnancy prevention programmes as risk minimisation measures","volume":"74","author":"Charlton","year":"2018","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Ventura, M., Maraschini, A., D\u2019aloja, P., Kirchmayer, U., Lega, I., Davoli, M., and Donati, S. (2018). Drug prescribing during pregnancy in a central region of Italy, 2008\u20132012. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5545-z"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1007\/s40264-016-0435-8","article-title":"Neonatal Adaptation Issues After Maternal Exposure to Prescription Drugs: Withdrawal Syndromes and Residual Pharmacological Effects","volume":"39","author":"Convertino","year":"2016","journal-title":"Drug Saf."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1111\/aogs.13925","article-title":"Uptrend in distress and psychiatric symptomatology in pregnant women during the coronavirus disease 2019 pandemic","volume":"99","author":"Berthelot","year":"2020","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fgwh.2020.00001","article-title":"Moms Are Not OK: COVID-19 and Maternal Mental Health","volume":"1","author":"Davenport","year":"2020","journal-title":"Front. Glob. Women\u2019s Health"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1111\/1471-0528.16381","article-title":"Prenatal anxiety and obstetric decisions among pregnant women in Wuhan and Chongqing during the COVID-19 outbreak: A cross-sectional study","volume":"127","author":"Liu","year":"2020","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_38","first-page":"205","article-title":"Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: A preliminary study","volume":"35","author":"Aksu","year":"2020","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Basu, A., Kim, H.H., Basaldua, R., Choi, K.W., Charron, L., Kelsall, N., Hernandez-Diaz, S., Wyszynski, D.F., and Koenen, K.C. (2021). A cross-national study of factors associated with women\u2019s perinatal mental health and wellbeing during the COVID-19 pandemic. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0249780"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"949239","DOI":"10.3389\/fpsyt.2022.949239","article-title":"The COVID-19 pandemic and mental health in pregnant women: A review article","volume":"13","author":"Arzamani","year":"2022","journal-title":"Front. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1002\/pds.5440","article-title":"COVID-19 pharmacotherapy utilization patterns during pregnancy: International Registry of Coronavirus Exposure in Pregnancy","volume":"31","author":"Westhoff","year":"2022","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1111\/bcp.15611","article-title":"COVID-19-related medicine utilization study in pregnancy: The COVI-PREG cohort","volume":"89","author":"Favre","year":"2023","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_43","unstructured":"(2022, April 23). Servicios Bifap. Available online: https:\/\/herramientas2bifap.aemps.es\/ServiciosBifap\/."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Mota, M., Huerta-\u00c1lvarez, C., Llorente, A., and Cea-Soriano, L. (2022). The Risk of SARS-CoV-2 Infection in Pregnant Women: An Observational Cohort Study Using the BIFAP Database. Healthcare, 10.","DOI":"10.3390\/healthcare10122429"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1002\/pds.5006","article-title":"Bifap the BIFAP Team Base de Datos para la Investigaci\u00f3n Farmacoepidemiol\u00f3gica en Atenci\u00f3n Primaria (BIFAP): A data resource for pharmacoepidemiology in Spain","volume":"29","author":"Gil","year":"2020","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_46","unstructured":"Gobernanza del Acceso a los Datos de BIFAP (2023, December 20). Agencia Espa\u00f1ola de Medicamentos y Productos Sanitarios. Available online: http:\/\/bifap.aemps.es\/gobernanza.php."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1002\/pds.4686","article-title":"Validation study of colorectal cancer diagnosis in the Spanish primary care database, BIFAP","volume":"28","author":"Gil","year":"2019","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_48","unstructured":"(2023, June 24). Informe_Previos_COVID-19_2022. Available online: https:\/\/www.isciii.es\/QueHacemos\/Servicios\/VigilanciaSaludPublicaRENAVE\/EnfermedadesTransmisibles\/Paginas\/Informe_Previos_COVID-19_2022.aspx."},{"key":"ref_49","unstructured":"Data Committee for Medicinal Products for Human Use (CHMP) (2023, December 20). Guideline on the Exposure to Medicinal Products during Pregnancy: Need for Post-Autorisation; EMEA\/CHMP\/313666\/2005. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/regulatory-procedural-guideline\/guideline-exposure-medicinal-products-during-pregnancy-need-post-authorisation-data_en.pdf."}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/2\/207\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:55:35Z","timestamp":1760104535000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/2\/207"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,6]]},"references-count":49,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["ph17020207"],"URL":"https:\/\/doi.org\/10.3390\/ph17020207","relation":{},"ISSN":["1424-8247"],"issn-type":[{"type":"electronic","value":"1424-8247"}],"subject":[],"published":{"date-parts":[[2024,2,6]]}}}