Objective: Our study determined the association of pregnancy with various clinical outcomes among women with COVID-19 infection. Methods: We conducted a retrospective, cohort, subgroup analysis of the Philippine CORONA Study datasets comparing the clinical/neurological manifestations and outcomes of pregnant and nonpregnant women admitted in 37 Philippine hospitals for COVID-19 infection. Results: We included 2448 women in the analyses (322 pregnant and 2.126 nonpregnant). Logistic regression models showed that crude odds ratio (OR) for mortality (OR 0.26 [95% CI 0.11, 0.66]), respiratory failure [OR 0.37 [95% CI 0.17, 0.80]), need for intensive care (OR 0.39 [95% CI 0.19, 0.80]), and prolonged length of hospital stay (OR 1.73 [95% CI 1.36, 2.19]) among pregnant women were significant. After adjusting for age, disease severity, and new-onset neurological symptoms, only the length of hospital stay remained significant (adjusted OR 1.99 [95% CI 1.56,2.54]). Cox regression models revealed that the unadjusted hazard ratio (HR) for mortality (HR 0.22 [95% CI 0.09, 0.55]) among pregnant women was statistically significant; however, after adjustment, the HR for mortality became nonsignificant. Conclusion: We did not find a significantly increased risk of mortality, respiratory failure, and need for ICU admission in pregnant women compared with nonpregnant women with COVID-19. However, the likelihood of hospital confinement beyond 14 days was twice more likely among pregnant women than nonpregnant women with COVID-19.
1 July 2024 in Philippine Journal of Obstetrics and Gynecology
Routine intimate hygiene care has a major contribution in maintaining overall urogenital and perineal health in women. However, Filipino women continue to experience a major surge in vulvar and vaginal symptoms across all age groups, in a context of major changes in lifestyles and risk factors impacting their genital health. Personal beliefs, preferences, apprehensions to discuss intimate topics with health-care practitioners (HCPs), availability of cleansing products in the market, and their affordability prevent many women from discussing the role of intimate hygiene care with their HCPs. Communication difficulties and lack of robust evidence, supporting optimal hygiene recommendations are some of the challenges experienced by HCPs. Through this review, the authors discuss the following factors: (i) Differing physiological needs and pathological effects that result from changing dynamics of microflora in the vulvar, perineal, and vaginal region across all age groups of women, (ii) Importance of focusing on perianal and perineal hygiene, and bowel habits, to improve the quality of vulvar hygiene and genital health, (iii) Designing approaches for HCPs to maintain genital health in the light of intimate hygiene, (iv) Recommending improvements in HCP-patient communications to help HCPs dispel the misconceptions pertaining to intimate hygiene practices, and (v) Highlighting the antimicrobial efficacy of feminine hygiene cleansers that preserve the natural microbiome and help maintain the vaginal pH within the normal range. These strategies can fill the knowledge gaps among HCPs, women, and their caregivers’ perspectives and help achieve optimal intimate hygiene.