Women who enter pregnancy with two or more pre-existing long-term physical or mental health conditions face substantially higher risks of several complications, according to a new UK-wide study published in The Lancet Public Health. Researchers found that compared with women with no long-term conditions, those with multiple conditions had a 20% higher risk of miscarriage, a 69% higher risk of severe nausea and vomiting, and around four times the risk of anxiety and depression.
Combined conditions linked to wider maternity risks
The study also reported more than double the risk of venous thromboembolism and a 42% higher risk of pre-eclampsia among women with multiple long-term conditions. For women with three or more conditions, the risk of venous thromboembolism was more than three-and-a-half times that of women with no long-term health conditions. Researchers said the risks rose with each additional condition.
The observational analysis, led by researchers from King’s College London, Queen’s University Belfast, Bristol NHS Foundation Trust, the University of Birmingham, Swansea University and the University of St Andrews, is described as the largest of its kind. It analysed more than 2.2 million pregnancies and birth events recorded between 2000 and 2022 across five datasets spanning England, Scotland, Wales and Northern Ireland.
Why the findings matter for UK maternity care
The researchers said around one in five pregnant women in the UK live with multiple long-term conditions, but the combined impact of those conditions has been poorly understood. They argued that maternity care pathways are still often organised around single conditions, and that the new findings point to a need to restructure services so care better reflects the complexity of these pregnancies.
Dr Steven Wambua, Research Fellow in Health Data Science at King’s College London and joint first author, said maternity care is still largely organised around single health conditions, while the new analysis showed that risks climb as conditions accumulate. Professor Krishnarajah Nirantharakumar, Clinical Professor of Public Health and Health Data Science at King’s College London and joint senior author, said the results make a strong case for recognising multiple long-term conditions as a marker of antenatal risk in their own right.
He added that clinicians should identify these women at maternity booking, assess physical and mental health needs together, and join up obstetric, primary care and mental health services around them. The authors also noted that, because the work was based on routinely collected health records, some conditions and outcomes may have been under-recorded or inconsistently recorded.
The study was funded by the UKRI Strategic Priorities Fund and the Department of Health and Social Care via the National Institute for Health and Care Research, and delivered by the Medical Research Council. The MuM-PreDiCT consortium said further work will examine birth and child outcomes and identify which combinations of conditions carry the greatest risk.
As the evidence base grows, the study adds fresh pressure on maternity services to move beyond one-size-fits-all pathways and recognise that women with multiple health conditions may need more integrated, personalised care throughout pregnancy.
Source: News Medical report
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