Daijiworld Media Network - London

London, Aug 22: Women who begin pregnancy with multiple long-term physical or mental health conditions may face a significantly higher risk of several pregnancy complications, including miscarriage, severe nausea and vomiting, and anxiety and depression, new research has found.

The study, published in The Lancet Public Health journal, found that women with multiple long-term conditions had a 20 per cent higher risk of miscarriage and a 69 per cent higher risk of severe nausea and vomiting compared with those without long-term conditions.

Researchers led by King's College London also found that women who entered pregnancy with two or more pre-existing conditions faced nearly four times the risk of antenatal anxiety and depression.

The study further found that women with multiple long-term conditions had more than twice the risk of venous thromboembolism, a condition involving blood clots in the veins, and a 42 per cent higher risk of pre-eclampsia, a pregnancy complication involving high blood pressure.

The risks increased with each additional long-term condition. For instance, women with three or more conditions had more than three-and-a-half times the risk of venous thromboembolism compared with women who had no long-term conditions.

“These findings make a strong case for recognising multiple long-term conditions as a marker of antenatal risk in its own right,” said senior author Krishnarajah Nirantharakumar, clinical professor of public health and health data science at King's College London.

He said such women should be identified at maternity booking, with their physical and mental health needs assessed together and obstetric, primary care and mental health services better coordinated.

“The near four-fold risk of antenatal anxiety and depression is particularly striking, and points to perinatal mental health support as an urgent priority,” Nirantharakumar said.

The researchers analysed more than 2.2 million pregnancies and birth events recorded between 2000 and 2022 across five datasets covering England, Scotland, Wales and Northern Ireland.

According to the researchers, women with multiple long-term conditions had increased risks of hyperemesis, vomiting, gestational diabetes, gestational hypertension, pre-eclampsia, obstetric cholestasis, placental abruption, venous thromboembolism, miscarriage, antenatal anxiety and antenatal depression.

The findings support earlier identification of women with multiple long-term conditions, integration of physical and mental healthcare throughout pregnancy, and inclusion of multimorbidity in pregnancy risk assessment and care planning, the researchers said.

However, the team cautioned that the study was observational and relied on routinely collected health records. As a result, some health conditions and pregnancy outcomes may have been under-recorded or recorded inconsistently.

The researchers said further efforts to identify and support women with multiple long-term conditions before and during pregnancy could help improve maternal care and enable healthcare services to address physical and mental health risks together.