Medication Use Among Nonhospitalized Pregnant Women With COVID-19 (CONSIGN Project)
Compared with non-pregnant women with COVID-19, pregnant women with COVID-19 were less likely to be prescribed analgesics, antiprotozoals, corticosteroids, psychoanaleptics and psycholeptics, and more likely to receive antithrombotics (e.g. 4.5% vs. 2.1% in the third trimester), as well as cough and cold preparations, nasal preparations, and drugs used in diabetes across all trimesters.
This study, conducted as part of the CONSIGN project, analyzed medication use among nonhospitalized pregnant women with COVID-19 across Europe and North America. Using a prospective individual patient data meta-analysis, researchers compared medication patterns before and after COVID-19 diagnosis and against two comparator groups: pregnant women without COVID-19 and nonpregnant women with COVID-19. The findings highlight notable differences in prescribing practices, including increased use of antithrombotics and cough/cold preparations among pregnant women with COVID-19, while analgesics and corticosteroids were less frequently prescribed compared to nonpregnant women. These results underscore the complexity of managing COVID-19 in pregnancy and reveal significant variation across countries, pointing to the need for harmonized clinical guidance.
Citation: de Bruin O, Maisonneuve E, Hurley E, Nordeng HME, Bérard A, Sheehy O, Kaul P, Shinde MU, Cosgrove A, Lyons JG, Messenger-Jones E, Kempner ME, Toh S, Hua W, Hernández-Muñoz JJ, Sahin L, Cesta CE, Hägg D, Gini R, Paoletti O, Poblador-Plou B, Jordan S, Thayer D, Rodríguez-Bernal CL, Sánchez-Sáez F, Lassalle R, Bernard MA, Alsina E, Ahmadizar F, Favre G, Panchaud A, Bloemenkamp KWM, Plueschke K, de Vries C, Siiskonen SJ, Sturkenboom MCJM; CONSIGN Collaboration Group. Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America. Pharmacoepidemiol Drug Saf. 2026 Jan;35(1):e70303. doi: 10.1002/pds.70303.
Antirheumatic Medication Use Among Pregnant Women With Rheumatoid Arthritis: A Norwegian Nationwide Drug Utilisation Study
Over 760,000 pregnancies in Norway between 2008 and 2018 were studied, and about 1 in 200 (0.5%) occurred in women with rheumatoid arthritis. Medication use decreased from 61% before pregnancy to 38% in the first trimester, 22% in the second, and 19% in the third trimester, before increasing again to 53% after delivery. Overall use of antirheumatic medication increased over time from 2008 to 2018, both before pregnancy (60% to 66%), during pregnancy (31% to 50%), and postpartum (45% to 54%), largely driven by increased use of TNF inhibitors.
This nationwide study linked Norwegian registry data to examine medication use patterns among pregnant women with rheumatoid arthritis (RA) from preconception through postpartum. The results show that while most women reduce or discontinue antirheumatic medications during pregnancy, use resumes after delivery. Over the study period, overall medication use increased, particularly for TNF inhibitors, reflecting evolving treatment strategies. The identification of three distinct usage patterns—NSAID-dominant, glucocorticoid plus pregnancy-compatible csDMARD continuation, and csDMARD interrupters—highlights the need for individualized counseling and careful monitoring to balance maternal health and fetal safety.
Citation: Choi EY, van Gelder MMHJ, Geisler BP, Oh IS, Nordeng HME. Antirheumatic medication use among pregnant women with rheumatoid arthritis: a Norwegian nationwide drug utilisation study. EClinicalMedicine. 2025 Nov. doi:10.1016/j.ero.2025.11.023.