Final | time | gap | L | Rem. | React. | 1. United States | _ | 3:51.55 | | 4 | WR | 0.59 | Kathleen Baker 58.54s, Lily King 1:04.48, Kelsi Worrell 56.30, Simone Manuel 52.23s | 2. Russia | _ | 3:53.38 | 1.83 | 8 | ER | Anastasia Fesikova 58.96s, Yulia Efimova 1:04.03, Svetlana Chimrova 56.99s, Veronika Popova 53.40s | 3. Australia | _ | 3:54.29 | 2.74 | 3 | | 0.67 | Emily Seebhom 58.53s, Taylor McKeon 1:06.29, Emma McKeon 56.78s, Bronte Campbell 52.69s | 4. Canada | _ | 3:54.86 | 3.31 | 2 | | 0.59 | Lylie Jacqueline Masse 58.31s, Kierra Smith 1:06.57, Penny Oleksiak 56.90s, Chantal van Landeghem 53.08s | 5. Sweden | _ | 3:55.28 | 3.73 | 6 | | 0.52 | Ida Lindborg 1:01.56, Jennie Johansson 1:05.76, Sarah Sjöström 55.03s, Michelle Coleman 52.93s | 6. China | _ | 3:57.69 | 6.14 | 7 | | 0.59 | Yuanhui Fu 1:00.52, Jinglin Shi 1:06.16, Yufei Zhang 57.39s, Menghui Zhu 53.62s | 7. Great Britain | _ | 3:59.51 | 7.96 | 1 | | 0.55 | Kathleen Dawson 1:00.24, Sarah Vasey 1:07,06, Charlotte Bridey Atkinson 58.29s, Freya Ann Alexandra Anderson 53.92s | 8. Italy | _ | 3:59.98 | 8.43 | 1 | | 0.65 | Margherita Panziera 1:01.12, Arianna Castiglioni 1:06.55, Ilaria Bianchi 57.64s, Federica Pellegrini 54.67s |
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