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Association between pre-pregnancy multimorbidity and adverse maternal outcomes: A systematic review.
- Source :
- Journal of Multimorbidity & Comorbidity; Jan-Dec2022, Vol. 12, p1-10, 10p
- Publication Year :
- 2022
-
Abstract
- Objective: We reviewed the literature on the association between pre-pregnancy multimorbidity (co-occurrence of two or more chronic conditions) and adverse maternal outcomes in pregnancy and postpartum. Data sources: Medline, EMBASE, and CINAHL were searched from inception to September, 2021. Study selection: Observational studies were eligible if they reported on the association between ≥ 2 co-occurring chronic conditions diagnosed before conception and any adverse maternal outcome in pregnancy or within 365 days of childbirth, had a comparison group, were peer-reviewed, and were written in English. Data extraction and synthesis: Two reviewers used standardized instruments to extract data and rate study quality and the certainty of evidence. A narrative synthesis was performed. Results: Of 6,381 studies retrieved, seven met our criteria. There were two prospective cohort studies, two retrospective cohort studies, and 3 cross-sectional studies, conducted in the United States (n=6) and Canada (n=1), and ranging in size from n=3,110 to n=57,326,681. Studies showed a dose-response relation between the number of co-occurring chronic conditions and risk of adverse maternal outcomes, including severe maternal morbidity or mortality, hypertensive disorders of pregnancy, and acute health care use in the perinatal period. Study quality was rated as strong (n=1), moderate (n=4), or weak (n=2), and the certainty of evidence was very low to moderate. Conclusion: Given the increasing prevalence of chronic disease risk factors such as advanced maternal age and obesity, more research is needed to understand the impact of pre-pregnancy multimorbidity on maternal health so that appropriate preconception and perinatal supports can be developed. [ABSTRACT FROM AUTHOR]
- Subjects :
- CINAHL database
HYPERTENSION in pregnancy
OBESITY
MEDICAL information storage & retrieval systems
CONFIDENCE intervals
CHRONIC diseases
SYSTEMATIC reviews
AGE distribution
RACE
PREGNANCY outcomes
RISK assessment
MEDICAL care use
PREGNANCY complications
PUERPERIUM
CRITICAL care medicine
SOCIAL classes
HEALTH behavior
DESCRIPTIVE statistics
RESEARCH funding
MEDLINE
MATERNAL mortality
SMOKING
ODDS ratio
COMORBIDITY
DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 26335565
- Volume :
- 12
- Database :
- Complementary Index
- Journal :
- Journal of Multimorbidity & Comorbidity
- Publication Type :
- Academic Journal
- Accession number :
- 161003207
- Full Text :
- https://doi.org/10.1177/26335565221096584