Factors associated with having COVID-19 among unvaccinated pregnant and non-pregnant women in Metro Manila, Philippines: a multicentre longitudinal cohort study
Emmanuel S Baja,
Erlidia F Llamas-Clark,
Francisco M Heralde,
Mayan U Lumandas,
Maria Esterlita T Villanueva-Uy,
Maria Stephanie Fay S Cagayan,
Leilani C Chavez-Coloma,
Eleyneth I Valencia,
Charizze Anne S Cabana,
Lea Bernadette H Espinosa,
Cynthia U Anzures,
Maria Lu D Andal,
Carolina Paula C Martin,
Patricia Nevira V Suarez,
Celine D Quanico,
Julia B Beltran,
Vanessa D de Guzman,
Ryan B Capitulo,
Arlene R Dominguez,
Abygail L Recio,
Jeremiah F Feliciano,
Paulyn Jean B Rosell-Ubial
Affiliations
Emmanuel S Baja
Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
Erlidia F Llamas-Clark
Department of Obstetrics and Gynecology, College of Medicine, University of the Philippines Manila, City of Manila, Philippines
Francisco M Heralde
Department of Molecular Biology and Biochemistry, College of Medicine, University of the Philippines Manila, City of Manila, Philippines
Mayan U Lumandas
Department of Virology, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
Maria Esterlita T Villanueva-Uy
Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, City of Manila, Metro Manila, Philippines
Maria Stephanie Fay S Cagayan
Department of Pharmacology and Toxicology, College of Medicine, University of the Philippines Manila, City of Manila, Philippines
Leilani C Chavez-Coloma
Department of Obstetrics and Gynecology, Jose R Reyes Memorial Medical Center, Manila, Philippines
Eleyneth I Valencia
Department of Obstetrics and Gynecology, Jose R Reyes Memorial Medical Center, Manila, Philippines
Charizze Anne S Cabana
Department of Obstetrics and Gynecology, Jose R Reyes Memorial Medical Center, Manila, Philippines
Lea Bernadette H Espinosa
Department of Obstetrics and Gynecology, Jose R Reyes Memorial Medical Center, Manila, Philippines
Cynthia U Anzures
Department of Obstetrics and Gynecology, Dr Jose Fabella Memorial Hospital, Manila, Philippines
Maria Lu D Andal
Department of Obstetrics and Gynecology, Dr Jose Fabella Memorial Hospital, Manila, Philippines
Carolina Paula C Martin
Department of Internal Medicine, Ospital ng Maynila Medical Center, Manila, Philippines
Patricia Nevira V Suarez
Department of Obstetrics and Gynecology, Ospital ng Maynila Medical Center, Manila, Philippines
Celine D Quanico
Department of Obstetrics and Gynecology, Ospital ng Maynila Medical Center, Manila, Philippines
Julia B Beltran
Department of Obstetrics and Gynecology, Ospital ng Maynila Medical Center, Manila, Philippines
Vanessa D de Guzman
Department of Obstetrics and Gynecology, Justice Jose Abad Santos General Hospital, Manila, Philippines
Ryan B Capitulo
Department of Obstetrics and Gynecology, Justice Jose Abad Santos General Hospital, Manila, Philippines
Arlene R Dominguez
Department of Obstetrics and Gynecology, Sta Ana Hospital, Manila, Philippines
Abygail L Recio
Department of Obstetrics and Gynecology, Sta Ana Hospital, Manila, Philippines
Jeremiah F Feliciano
University of the Philippines Manila College of Medicine, Manila, Philippines
Paulyn Jean B Rosell-Ubial
Department of Health Policy and Administration, University of the Philippines Manila College of Public Health, Manila, Philippines
Objective To determine the potential risk factors associated with having COVID-19 among unvaccinated pregnant and non-pregnant women.Design A multicentre prospective cohort study among eligible women in Metro Manila, Philippines, from 2020 to 2022.Setting Five national and local hospital research sites altogether recruited and screened 500 consenting eligible individuals.Participants Pregnant and non-pregnant participants meeting the eligibility criteria were admitted for a reverse-transcription PCR determination of SARS-CoV-2, pregnancy testing and ultrasound, and an interview with an administered questionnaire.Exposures Primary exposure was pregnancy; secondary exposures involve sociodemographic, lifestyle and obstetric-gynaecologic factors.Outcome measure Outcome being measured was COVID-19 status.Results The significant COVID-19 risk factors were: pregnancy (PR=1.184, 95% CI 1.096, 1.279), having a white-collar job (PR=1.123, 95% CI 1.02, 1.235), travelling abroad (PR=1.369, 95% CI 1.083, 1.173) and being infected by at least one vaccine-preventable disease (VPD) (PR=1.208, 95% CI 1.113, 1.310). Protective factors included having graduate-level education (PR=0.787, 95% CI 0.649, 0.954), immunisation against a VPD (PR=0.795, 95% CI 0.733, 0.862) and practising contraception (PR=0.889, 95% CI 0.824, 0.960).Conclusion This study is the first in the country to determine the risks influencing COVID-19 infection among unvaccinated pregnant and non-pregnant women. Pregnancy is a significant risk for COVID-19 among women in Metro Manila. Educational attainment and positive health behaviours seem to confer protection. Occupations and activities that increase the frequency of interactions, as well as history of communicable diseases may predispose women to COVID-19. Further studies are needed to elucidate the development of the disease in pregnant women, including the maternal and neonatal effects of COVID-19 via potential vertical mechanisms of transmission.
