Maternal and child outcomes for pregnant women with pre-existing multiple long-term conditions: protocol for an observational study in the UK.

Journal: BMJ open

Volume: 13

Issue: 2

Year of Publication: 2023

Affiliated Institutions:  Institute of Applied Health Research, University of Birmingham, Birmingham, UK. Centre for Women's Mental Health, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK. Centre for Public Health, Queen's University Belfast, Belfast, UK. Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Trust, Bradford, UK. Patient and Public Representative, London, UK. Division of Population and Behavioural Sciences, University of St Andrews School of Medicine, St Andrews, UK. Guy's and St Thomas' NHS Foundation Trust, London, UK. Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK. Data Science, Medical School, Swansea University, Swansea, UK. WHO Collaborating Centre for Global Women's Health, University of Birmingham Institute of Metabolism and Systems Research, Birmingham, UK. Institute of Applied Health Research, University of Birmingham, Birmingham, UK k.nirantharan@bham.ac.uk. Aberdeen Centre for Women's Health Research, University of Aberdeen School of Medicine Medical Sciences and Nutrition, Aberdeen, UK.

Abstract summary 

One in five pregnant women has multiple pre-existing long-term conditions in the UK. Studies have shown that maternal multiple long-term conditions are associated with adverse outcomes. This observational study aims to compare maternal and child outcomes for pregnant women with multiple long-term conditions to those without multiple long-term conditions (0 or 1 long-term conditions).Pregnant women aged 15-49 years old with a conception date between 2000 and 2019 in the UK will be included with follow-up till 2019. The data source will be routine health records from all four UK nations (Clinical Practice Research Datalink (England), Secure Anonymised Information Linkage (Wales), Scotland routine health records and Northern Ireland Maternity System) and the Born in Bradford birth cohort. The exposure of two or more pre-existing, long-term physical or mental health conditions will be defined from a list of health conditions predetermined by women and clinicians. The association of maternal multiple long-term conditions with (a) antenatal, (b) peripartum, (c) postnatal and long-term and (d) mental health outcomes, for both women and their children will be examined. Outcomes of interest will be guided by a core outcome set. Comparisons will be made between pregnant women with and without multiple long-term conditions using modified Poisson and Cox regression. Generalised estimating equation will account for the clustering effect of women who had more than one pregnancy episode. Where appropriate, multiple imputation with chained equation will be used for missing data. Federated analysis will be conducted for each dataset and results will be pooled using random-effects meta-analyses.Approval has been obtained from the respective data sources in each UK nation. Study findings will be submitted for publications in peer-reviewed journals and presented at key conferences.

Authors & Co-authors:  Lee Siang Ing SI Hope Holly H O'Reilly Dermot D Kent Lisa L Santorelli Gillian G Subramanian Anuradhaa A Moss Ngawai N Azcoaga-Lorenzo Amaya A Fagbamigbe Adeniyi Francis AF Nelson-Piercy Catherine C Yau Christopher C McCowan Colin C Kennedy Jonathan Ian JI Phillips Katherine K Singh Megha M Mhereeg Mohamed M Cockburn Neil N Brocklehurst Peter P Plachcinski Rachel R Riley Richard D RD Thangaratinam Shakila S Brophy Sinead S Hemali Sudasinghe Sudasing Pathirannehelage Buddhika SPB Agrawal Utkarsh U Vowles Zoe Z Abel Kathryn Mary KM Nirantharakumar Krishnarajah K Black Mairead M Eastwood Kelly-Ann KA

Study Outcome 

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Statistics
Citations :  Eggleton EJ, McMurrugh KJ, Aiken CE. Maternal pregnancy outcomes in women with cardiomyopathy: a systematic review and meta-analysis. Am J Obstet Gynecol 2022;227:582–92. 10.1016/j.ajog.2022.05.039
Authors :  30
Identifiers
Doi : e068718
SSN : 2044-6055
Study Population
Women,Female
Mesh Terms
Female
Other Terms
EPIDEMIOLOGY;Maternal medicine;OBSTETRICS
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England