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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 
,
Amaya Azcoaga-Lorenzo ,
Utkarsh Agrawal ,
Jonathan Kennedy,
Adeniyi Francis Fagbamigbe ,
Holly Hope ,
Anuradhaa Subramanian ,
Astha Anand ,
Beck Taylor ,
Catherine Nelson-Piercy ,
Christine Damase-Michel ,
Christopher Yau ,
Francesca Crowe ,
Gillian Santorelli ,
Kelly-Ann Eastwood ,
Zoe Vowles ,
Maria Loane ,
Ngawai Moss ,
Peter Brocklehurst ,
Rachel Plachcinski ,
Shakila Thangaratinam ,
Mairead Black ,
Dermot O’Reilly ,
Kathryn M. Abel ,
Sinead Brophy ,
Krishnarajah Nirantharakumar ,
Colin McCowan
,
Amaya Azcoaga-Lorenzo ,
Utkarsh Agrawal ,
Jonathan Kennedy,
Adeniyi Francis Fagbamigbe ,
Holly Hope ,
Anuradhaa Subramanian ,
Astha Anand ,
Beck Taylor ,
Catherine Nelson-Piercy ,
Christine Damase-Michel ,
Christopher Yau ,
Francesca Crowe ,
Gillian Santorelli ,
Kelly-Ann Eastwood ,
Zoe Vowles ,
Maria Loane ,
Ngawai Moss ,
Peter Brocklehurst ,
Rachel Plachcinski ,
Shakila Thangaratinam ,
Mairead Black ,
Dermot O’Reilly ,
Kathryn M. Abel ,
Sinead Brophy ,
Krishnarajah Nirantharakumar ,
Colin McCowan
BMC Pregnancy and Childbirth, Volume: 22, Issue: 1
Swansea University Authors:
Jonathan Kennedy, Sinead Brophy
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DOI (Published version): 10.1186/s12884-022-04442-3
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...
| Published in: | BMC Pregnancy and Childbirth |
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| ISSN: | 1471-2393 |
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Springer Science and Business Media LLC
2022
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<?xml version="1.0"?><rfc1807><datestamp>2022-08-25T13:39:47.6567242</datestamp><bib-version>v2</bib-version><id>60754</id><entry>2022-08-05</entry><title>Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study</title><swanseaauthors><author><sid>08163d1f58d7fefcb1c695bcc2e0ef68</sid><ORCID/><firstname>Jonathan</firstname><surname>Kennedy</surname><name>Jonathan Kennedy</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>84f5661b35a729f55047f9e793d8798b</sid><ORCID>0000-0001-7417-2858</ORCID><firstname>Sinead</firstname><surname>Brophy</surname><name>Sinead Brophy</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-08-05</date><deptcode>HDAT</deptcode><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.</abstract><type>Journal Article</type><journal>BMC Pregnancy and Childbirth</journal><volume>22</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1471-2393</issnElectronic><keywords>Multimorbidity, Multiple chronic conditions, Multiple long-term conditions, Pregnancy, Maternity,Epidemiology</keywords><publishedDay>11</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-02-11</publishedDate><doi>10.1186/s12884-022-04442-3</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><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.</funders><projectreference/><lastEdited>2022-08-25T13:39:47.6567242</lastEdited><Created>2022-08-05T13:00:02.2907918</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Siang Ing</firstname><surname>Lee</surname><orcid>0000-0002-2332-5452</orcid><order>1</order></author><author><firstname>Amaya</firstname><surname>Azcoaga-Lorenzo</surname><orcid>0000-0003-3307-878x</orcid><order>2</order></author><author><firstname>Utkarsh</firstname><surname>Agrawal</surname><orcid>0000-0001-5181-6120</orcid><order>3</order></author><author><firstname>Jonathan</firstname><surname>Kennedy</surname><orcid/><order>4</order></author><author><firstname>Adeniyi Francis</firstname><surname>Fagbamigbe</surname><orcid>0000-0001-9184-8258</orcid><order>5</order></author><author><firstname>Holly</firstname><surname>Hope</surname><orcid>0000-0002-4834-6719</orcid><order>6</order></author><author><firstname>Anuradhaa</firstname><surname>Subramanian</surname><orcid>0000-0001-8875-7363</orcid><order>7</order></author><author><firstname>Astha</firstname><surname>Anand</surname><orcid>0000-0003-0494-321x</orcid><order>8</order></author><author><firstname>Beck</firstname><surname>Taylor</surname><orcid>0000-0002-3559-7922</orcid><order>9</order></author><author><firstname>Catherine</firstname><surname>Nelson-Piercy</surname><orcid>0000-0001-9311-1196</orcid><order>10</order></author><author><firstname>Christine</firstname><surname>Damase-Michel</surname><orcid>0000-0001-5018-0108</orcid><order>11</order></author><author><firstname>Christopher</firstname><surname>Yau</surname><orcid>0000-0001-7615-8523</orcid><order>12</order></author><author><firstname>Francesca</firstname><surname>Crowe</surname><orcid>0000-0003-4026-1726</orcid><order>13</order></author><author><firstname>Gillian</firstname><surname>Santorelli</surname><orcid>0000-0003-0427-1783</orcid><order>14</order></author><author><firstname>Kelly-Ann</firstname><surname>Eastwood</surname><orcid>0000-0003-3689-0490</orcid><order>15</order></author><author><firstname>Zoe</firstname><surname>Vowles</surname><orcid>0000-0001-6989-2180</orcid><order>16</order></author><author><firstname>Maria</firstname><surname>Loane</surname><orcid>0000-0002-1206-3637</orcid><order>17</order></author><author><firstname>Ngawai</firstname><surname>Moss</surname><orcid>0000-0001-9369-5072</orcid><order>18</order></author><author><firstname>Peter</firstname><surname>Brocklehurst</surname><orcid>0000-0002-9950-6751</orcid><order>19</order></author><author><firstname>Rachel</firstname><surname>Plachcinski</surname><orcid>0000-0001-9908-0773</orcid><order>20</order></author><author><firstname>Shakila</firstname><surname>Thangaratinam</surname><orcid>0000-0002-4254-460x</orcid><order>21</order></author><author><firstname>Mairead</firstname><surname>Black</surname><orcid>0000-0002-6841-8601</orcid><order>22</order></author><author><firstname>Dermot</firstname><surname>O’Reilly</surname><orcid>0000-0002-9181-0652</orcid><order>23</order></author><author><firstname>Kathryn M.</firstname><surname>Abel</surname><orcid>0000-0003-3538-8896</orcid><order>24</order></author><author><firstname>Sinead</firstname><surname>Brophy</surname><orcid>0000-0001-7417-2858</orcid><order>25</order></author><author><firstname>Krishnarajah</firstname><surname>Nirantharakumar</surname><orcid>0000-0002-6816-1279</orcid><order>26</order></author><author><firstname>Colin</firstname><surname>McCowan</surname><orcid>0000-0002-9466-833x</orcid><order>27</order></author></authors><documents><document><filename>60754__24873__e4ac87c180344fbe9d8daf3a2ce1ef90.pdf</filename><originalFilename>60754.pdf</originalFilename><uploaded>2022-08-05T13:01:58.4959776</uploaded><type>Output</type><contentLength>1125021</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
| spelling |
2022-08-25T13:39:47.6567242 v2 60754 2022-08-05 Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study 08163d1f58d7fefcb1c695bcc2e0ef68 Jonathan Kennedy Jonathan Kennedy true false 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 2022-08-05 HDAT 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. Journal Article BMC Pregnancy and Childbirth 22 1 Springer Science and Business Media LLC 1471-2393 Multimorbidity, Multiple chronic conditions, Multiple long-term conditions, Pregnancy, Maternity,Epidemiology 11 2 2022 2022-02-11 10.1186/s12884-022-04442-3 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 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. 2022-08-25T13:39:47.6567242 2022-08-05T13:00:02.2907918 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Siang Ing Lee 0000-0002-2332-5452 1 Amaya Azcoaga-Lorenzo 0000-0003-3307-878x 2 Utkarsh Agrawal 0000-0001-5181-6120 3 Jonathan Kennedy 4 Adeniyi Francis Fagbamigbe 0000-0001-9184-8258 5 Holly Hope 0000-0002-4834-6719 6 Anuradhaa Subramanian 0000-0001-8875-7363 7 Astha Anand 0000-0003-0494-321x 8 Beck Taylor 0000-0002-3559-7922 9 Catherine Nelson-Piercy 0000-0001-9311-1196 10 Christine Damase-Michel 0000-0001-5018-0108 11 Christopher Yau 0000-0001-7615-8523 12 Francesca Crowe 0000-0003-4026-1726 13 Gillian Santorelli 0000-0003-0427-1783 14 Kelly-Ann Eastwood 0000-0003-3689-0490 15 Zoe Vowles 0000-0001-6989-2180 16 Maria Loane 0000-0002-1206-3637 17 Ngawai Moss 0000-0001-9369-5072 18 Peter Brocklehurst 0000-0002-9950-6751 19 Rachel Plachcinski 0000-0001-9908-0773 20 Shakila Thangaratinam 0000-0002-4254-460x 21 Mairead Black 0000-0002-6841-8601 22 Dermot O’Reilly 0000-0002-9181-0652 23 Kathryn M. Abel 0000-0003-3538-8896 24 Sinead Brophy 0000-0001-7417-2858 25 Krishnarajah Nirantharakumar 0000-0002-6816-1279 26 Colin McCowan 0000-0002-9466-833x 27 60754__24873__e4ac87c180344fbe9d8daf3a2ce1ef90.pdf 60754.pdf 2022-08-05T13:01:58.4959776 Output 1125021 application/pdf Version of Record true © The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License true eng http://creativecommons.org/licenses/by/4.0/ |
| title |
Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study |
| spellingShingle |
Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study Jonathan Kennedy Sinead Brophy |
| title_short |
Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study |
| title_full |
Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study |
| title_fullStr |
Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study |
| title_full_unstemmed |
Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study |
| title_sort |
Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study |
| author_id_str_mv |
08163d1f58d7fefcb1c695bcc2e0ef68 84f5661b35a729f55047f9e793d8798b |
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08163d1f58d7fefcb1c695bcc2e0ef68_***_Jonathan Kennedy 84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy |
| author |
Jonathan Kennedy Sinead Brophy |
| author2 |
Siang Ing Lee Amaya Azcoaga-Lorenzo Utkarsh Agrawal Jonathan Kennedy Adeniyi Francis Fagbamigbe Holly Hope Anuradhaa Subramanian Astha Anand Beck Taylor Catherine Nelson-Piercy Christine Damase-Michel Christopher Yau Francesca Crowe Gillian Santorelli Kelly-Ann Eastwood Zoe Vowles Maria Loane Ngawai Moss Peter Brocklehurst Rachel Plachcinski Shakila Thangaratinam Mairead Black Dermot O’Reilly Kathryn M. Abel Sinead Brophy Krishnarajah Nirantharakumar Colin McCowan |
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Journal article |
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BMC Pregnancy and Childbirth |
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22 |
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1 |
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2022 |
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Swansea University |
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1471-2393 |
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10.1186/s12884-022-04442-3 |
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Springer Science and Business Media LLC |
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Faculty of Medicine, Health and Life Sciences |
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Faculty of Medicine, Health and Life Sciences |
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Faculty of Medicine, Health and Life Sciences |
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Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine |
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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. |
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2022-02-11T04:19:07Z |
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11.012656 |