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Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018 : a population-based cross-sectional study
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MuM-PreDiCT Group (Including:
). (2022) Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018 : a population-based cross-sectional study. BMC Pregnancy and Childbirth, 22 (1). 120. doi:10.1186/s12884-022-04442-3 ISSN 1471-2393.
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Official URL: http://doi.org/10.1186/s12884-022-04442-3
Abstract
Background
Although 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 design
Pregnant 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.
Results
The 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).
Conclusion
Multimorbidity 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.
Item Type: | Journal Article | |||||||||||||||||||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine R Medicine > RG Gynecology and obstetrics |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | |||||||||||||||||||||
Library of Congress Subject Headings (LCSH): | Comorbidity -- Great Britain, Chronic diseases -- Epidemiology, Pregnancy -- Complications -- Research, Pregnancy, Childbirth, Women -- Health and hygiene -- Great Britain, Mothers| -- Mortality -- Great Britain -- Statistics | |||||||||||||||||||||
Journal or Publication Title: | BMC Pregnancy and Childbirth | |||||||||||||||||||||
Publisher: | BioMed Central Ltd. | |||||||||||||||||||||
ISSN: | 1471-2393 | |||||||||||||||||||||
Official Date: | 11 February 2022 | |||||||||||||||||||||
Dates: |
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Volume: | 22 | |||||||||||||||||||||
Number: | 1 | |||||||||||||||||||||
Article Number: | 120 | |||||||||||||||||||||
DOI: | 10.1186/s12884-022-04442-3 | |||||||||||||||||||||
Status: | Peer Reviewed | |||||||||||||||||||||
Publication Status: | Published | |||||||||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||||||||||||||
Date of first compliant deposit: | 22 May 2023 | |||||||||||||||||||||
Date of first compliant Open Access: | 23 May 2023 | |||||||||||||||||||||
RIOXX Funder/Project Grant: |
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