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Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study

Siang Ing Lee Orcid Logo, Amaya Azcoaga-Lorenzo Orcid Logo, Utkarsh Agrawal Orcid Logo, Jonathan Kennedy, Adeniyi Francis Fagbamigbe Orcid Logo, Holly Hope Orcid Logo, Anuradhaa Subramanian Orcid Logo, Astha Anand Orcid Logo, Beck Taylor Orcid Logo, Catherine Nelson-Piercy Orcid Logo, Christine Damase-Michel Orcid Logo, Christopher Yau Orcid Logo, Francesca Crowe Orcid Logo, Gillian Santorelli Orcid Logo, Kelly-Ann Eastwood Orcid Logo, Zoe Vowles Orcid Logo, Maria Loane Orcid Logo, Ngawai Moss Orcid Logo, Peter Brocklehurst Orcid Logo, Rachel Plachcinski Orcid Logo, Shakila Thangaratinam Orcid Logo, Mairead Black Orcid Logo, Dermot O’Reilly Orcid Logo, Kathryn M. Abel Orcid Logo, Sinead Brophy Orcid Logo, Krishnarajah Nirantharakumar Orcid Logo, Colin McCowan Orcid Logo

BMC Pregnancy and Childbirth, Volume: 22, Issue: 1

Swansea University Authors: Jonathan Kennedy, Sinead Brophy Orcid Logo

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Abstract

BackgroundAlthough maternal death is rare in the United Kingdom, 90% of these women had multiple health/social problems. This study aims to estimate the prevalence of pre-existing multimorbidity (two or more long-term physical or mental health conditions) in pregnant women in the United Kingdom (Eng...

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Published in: BMC Pregnancy and Childbirth
ISSN: 1471-2393
Published: Springer Science and Business Media LLC 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa60754
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Abstract: BackgroundAlthough maternal death is rare in the United Kingdom, 90% of these women had multiple health/social problems. This study aims to estimate the prevalence of pre-existing multimorbidity (two or more long-term physical or mental health conditions) in pregnant women in the United Kingdom (England, Northern Ireland, Wales and Scotland).Study designPregnant women aged 15–49 years with a conception date 1/1/2018 to 31/12/2018 were included in this population-based cross-sectional study, using routine healthcare datasets from primary care: Clinical Practice Research Datalink (CPRD, United Kingdom, n = 37,641) and Secure Anonymized Information Linkage databank (SAIL, Wales, n = 27,782), and secondary care: Scottish Morbidity Records with linked community prescribing data (SMR, Tayside and Fife, n = 6099). Pre-existing multimorbidity preconception was defined from 79 long-term health conditions prioritised through a workshop with patient representatives and clinicians.ResultsThe prevalence of multimorbidity was 44.2% (95% CI 43.7–44.7%), 46.2% (45.6–46.8%) and 19.8% (18.8–20.8%) in CPRD, SAIL and SMR respectively. When limited to health conditions that were active in the year before pregnancy, the prevalence of multimorbidity was still high (24.2% [23.8–24.6%], 23.5% [23.0–24.0%] and 17.0% [16.0 to 17.9%] in the respective datasets). Mental health conditions were highly prevalent and involved 70% of multimorbidity CPRD: multimorbidity with ≥one mental health condition/s 31.3% [30.8–31.8%]).After adjusting for age, ethnicity, gravidity, index of multiple deprivation, body mass index and smoking, logistic regression showed that pregnant women with multimorbidity were more likely to be older (CPRD England, adjusted OR 1.81 [95% CI 1.04–3.17] 45–49 years vs 15–19 years), multigravid (1.68 [1.50–1.89] gravidity ≥ five vs one), have raised body mass index (1.59 [1.44–1.76], body mass index 30+ vs body mass index 18.5–24.9) and smoked preconception (1.61 [1.46–1.77) vs non-smoker).ConclusionMultimorbidity is prevalent in pregnant women in the United Kingdom, they are more likely to be older, multigravid, have raised body mass index and smoked preconception. Secondary care and community prescribing dataset may only capture the severe spectrum of health conditions. Research is needed urgently to quantify the consequences of maternal multimorbidity for both mothers and children.
Keywords: Multimorbidity, Multiple chronic conditions, Multiple long-term conditions, Pregnancy, Maternity,Epidemiology
College: Faculty of Medicine, Health and Life Sciences
Funders: This work was funded by the Strategic Priority Fund “Tackling multimorbidity at scale” programme (grant number MR/W014432/1) delivered by the Medical Research Council and the National Institute for Health Research in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council. BT was funded by the National Institute for Health Research (NIHR) West Midlands Applied Research Collaboration. AA and SIL were funded as NIHR Academic Clinical Fellows. The views expressed are those of the author and not necessarily those of the funders, the NIHR or the UK Department of Health and Social Care.
Issue: 1