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

BMC Pregnancy and Childbirth

Mairead Black¹  Gillian Santorelli²  Dermot O’Reilly³  Kelly-Ann Eastwood⁴  Holly Hope⁵  Kathryn M. Abel⁶  Sinead Brophy⁷  Jonathan I. Kennedy⁷  Christopher Yau⁸  Amaya Azcoaga-Lorenzo⁹  Utkarsh Agrawal⁹  Colin McCowan⁹  Adeniyi Francis Fagbamigbe^1,10  Zoe Vowles^1,11  Catherine Nelson-Piercy^1,11  Peter Brocklehurst^1,12  Siang Ing Lee^1,12  Beck Taylor^1,12  Astha Anand^1,12  Francesca Crowe^1,12  Krishnarajah Nirantharakumar^1,12  Anuradhaa Subramanian^1,12  Christine Damase-Michel^1,13  Rachel Plachcinski^1,14  Ngawai Moss^1,14  Maria Loane^1,15  Shakila Thangaratinam^1,16 

[1] Aberdeen Centre for Women’s Health Research, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK;Bradford Institute for Health Research, Bradford, UK;Centre for Public Health, Queen’s University of Belfast, Belfast, UK;Centre for Public Health, Queen’s University of Belfast, Belfast, UK;St Michael’s Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK;Centre for Women’s Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK;Centre for Women’s Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK;Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK;Data Science, Medical School, Swansea University, Swansea, UK;Division of Informatics, Imaging and Data Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK;Health Data Research, London, UK;Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK;Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK;Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria;Guy’s and St. Thomas’ NHS Foundation Trust, London, UK;Institute of Applied Health Research, IOEM Building, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK;Medical and Clinical Pharmacology, School of Medicine, Université Toulouse III, Toulouse, France;INSERM, Centre for Epidemiology and Research in Population Health (CERPOP), CIC 1436, Toulouse, France;Patient and Public Representative, London, UK;The Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK;WHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK;Department of Obstetrics and Gynaecology, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK;

关键词: Multimorbidity;    Multiple chronic conditions;    Multiple long-term conditions;    Pregnancy;    Maternity;    Epidemiology;   

DOI  :  10.1186/s12884-022-04442-3

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY