| アブストラクト | 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. |
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| 投稿者 | Lee, Siang Ing; Azcoaga-Lorenzo, Amaya; Agrawal, Utkarsh; Kennedy, Jonathan I; Fagbamigbe, Adeniyi Francis; Hope, Holly; Subramanian, Anuradhaa; Anand, Astha; Taylor, Beck; Nelson-Piercy, Catherine; Damase-Michel, Christine; Yau, Christopher; Crowe, Francesca; Santorelli, Gillian; Eastwood, Kelly-Ann; Vowles, Zoe; Loane, Maria; Moss, Ngawai; Brocklehurst, Peter; Plachcinski, Rachel; Thangaratinam, Shakila; Black, Mairead; O'Reilly, Dermot; Abel, Kathryn M; Brophy, Sinead; Nirantharakumar, Krishnarajah; McCowan, Colin |
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| 組織名 | Institute of Applied Health Research, IOEM Building, University of Birmingham,;Edgbaston, Birmingham, B15 2TT, UK.;Division of Population and Behavioural Sciences, School of Medicine, University;of St Andrews, St Andrews, UK.;Data Science, Medical School, Swansea University, Swansea, UK.;Department of Epidemiology and Medical Statistics, College of Medicine,;University of Ibadan, Ibadan, Nigeria.;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.;Guy's and St. Thomas' NHS Foundation Trust, London, UK.;Medical and Clinical Pharmacology, School of Medicine, Universite Toulouse III,;Toulouse, France.;INSERM, Centre for Epidemiology and Research in Population Health (CERPOP), CIC;1436, Toulouse, France.;Division of Informatics, Imaging and Data Sciences, Faculty of Biology Medicine;and Health, The University of Manchester, Manchester, UK.;Health Data Research, London, UK.;Bradford Institute for Health Research, Bradford, UK.;Centre for Public Health, Queen's University of Belfast, Belfast, UK.;St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust,;Bristol, UK.;The Institute of Nursing and Health Research, Ulster University, Newtownabbey,;UK.;Patient and Public Representative, London, 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.;Aberdeen Centre for Women's Health Research, School of Medicine, Medical Science;and Nutrition, University of Aberdeen, Aberdeen, UK.;Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.;Edgbaston, Birmingham, B15 2TT, UK. K.Nirantharan@bham.ac.uk. |
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