ArticleBJOG : an international journal of obstetrics and gynaecology2026
Multiple Chronic Conditions Before Pregnancy and Risk of Adverse Maternal Health Outcomes: Population-Based Cohort Study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global prevalence of multimorbidity during pregnancy: a systematic review and meta-analysis.Reproductive health · 2026Pooled it
- Multiple Maternal Chronic Conditions and Risk of Severe Neonatal Morbidity and Mortality.JAMA network open · 2026Article
- Prescribed medicines among pregnant women attending health facilities in Eritrea: patterns, safety, and determinants.Frontiers in pharmacology · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
objectiveTo assess the risks of perinatal emergency department (ED) use, hospitalisation and severe maternal morbidity or mortality (SMM-M) associated with preconception MCC, according to the number of chronic conditions, complex MCC and co-occurring cardiometabolic conditions.
designPopulation-based cohort study.
settingOntario, Canada. POPULATION: Females aged 13-54 years, with a recognised pregnancy, 2012-2021.
methodsModified Poisson regression was used to generate adjusted relative risks (aRRs) according to the number of chronic conditions, complex MCC (≥ 3 chronic conditions affecting ≥ 3 body systems) and co-occurring cardiometabolic conditions. aRRs were adjusted for age, parity, income quintile, rurality and immigrant/refugee status.
main outcome measuresED use, hospitalisation and SMM-M from the estimated date of conception to 42 days postpartum.
resultsIn total, 894 042 individuals had no pre-pregnancy chronic condition; 357 398 had 1; 94 427 had 2; and 27 326 had ≥ 3 chronic conditions. Relative to those without a chronic condition, the aRR for ED use increased with 1 (1.26, 95% CI 1.25-1.27), 2 (1.55, 1.54-1.56) and ≥ 3 (1.86, 1.85-1.88) conditions. For hospitalisations, the corresponding aRRs were 1.45 (1.43-1.47), 2.06 (2.02-2.10) and 3.18 (3.09-3.27). For SMM-M, the corresponding aRRs were 1.38 (1.35-1.42), 1.82 (1.75-1.90) and 2.75 (2.59-2.92). SMM-M risk was even more pronounced with complex MCC (aRR 2.92, 95% CI 2.72-3.14), and ≥ 3 cardiometabolic conditions (aRR 5.45, 95% CI 4.29-6.91).
conclusionsMCC, especially complex or cardiometabolic MCC, is associated with elevated risk of maternal morbidity. Multidisciplinary patient-centred care may mitigate these risks.
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