New Delhi

Beginning pregnancy with multiple long-term physical or mental health conditions could be related with a 20 per cent higher risk of miscarriage and 69 per cent higher risk of severe nausea and vomiting, new research suggests.

Findings published in The Lancet Public Health journal also indicate a four-fold risk of anxiety and depression among women who begin pregnancy with two or more pre-existing conditions.

Researchers, led by King's College London, also found that those with multiple long-term conditions had more than double the risk of venous thromboembolism and a 42 per cent higher risk of pre-eclampsia (high blood pressure in pregnancy), compared to those without long-term conditions.

Each additional condition was found to increase risks of complications -- for example, risk of venous thromboembolism was more than three-and-a-half times among women with three or more conditions, compared to women with 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. That means identifying these women at maternity booking, assessing physical and mental health needs together, and joining up obstetric, primary care and mental health services around them," senior author Krishnarajah Nirantharakumar, clinical professor of public health and health data science at King's College London, said.

"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 over 2.2 million pregnancies and birth events recorded between 2000 and 2022 in five datasets spanning England, Scotland, Wales and Northern Ireland.

"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 authors wrote.

The findings support an earlier identification of women with multiple long-term conditions, integration of physical and mental care throughout pregnancy and incorporation of multimorbidity into risk assessment and care planning, the team said.

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They noted that, as an observational study using routinely collected health records, some conditions and outcomes may be under-recorded or inconsistently recorded.