Women who enter pregnancy with two or more long-term physical or mental health conditions face higher risks of a range of pregnancy complications, according to new UK-wide research involving Swansea University.

Published in The Lancet Public Health, the study analysed more than 2.2 million pregnancies and birth events recorded between 2000 and 2022 across England, Scotland, Wales and Northern Ireland.

Compared with women without long-term conditions, those living with multiple conditions had a 20% higher risk of miscarriage, a 42% higher risk of pre-eclampsia (a pregnancy complication that causes high blood pressure) and more than twice the risk of venous thromboembolism (where a blood clot forms inside a vein, such as in deep vein thrombosis and pulmonary embolism).

They also had higher risks of gestational diabetes, placental abruption, severe nausea and vomiting, and antenatal anxiety and depression. The risks generally increased as the number of long-term conditions increased.

Researchers from Centre for Population Health (CPH) at Swansea University were among the wider UK research team involved in the MuM-PreDiCT study, alongside colleagues from King’s College London, Queen’s University Belfast, Bristol NHS Foundation Trust, the University of Birmingham and the University of St Andrews.

The findings highlight the challenges of providing maternity care for women whose health needs span multiple conditions, rather than fitting within a single-condition pathway.

Ayodele Opatola, a co-author of the study from CPH, said: “Being part of this UK-wide study has helped bring together evidence from across the four nations to better understand the health challenges faced by women with multiple long-term conditions during pregnancy. The findings highlight the importance of recognising the full range of a woman’s health needs and considering how maternity care can better support women with more complex health needs.”

The findings reinforce the need for maternity services to consider multiple long-term conditions when assessing antenatal risk and planning care, including physical and mental health needs.

Read the full study in The Lancet Public Health: Antenatal outcomes for women with multiple long-term conditions in pregnancy

Data sources: Clinical Practice Research Datalink (CPRD) Gold, Born in Bradford (BiB), the SAIL Databank, Scottish routine health records (SRHR) and the Northern Ireland Maternity System (NIMATS).