Maternal multimorbidity during pregnancy and after childbirth in women in low- and middle-income countries: a systematic literature review.

McCauley, Mary ORCID: https://orcid.org/0000-0003-1446-0625, Zafar, Shamsa and van den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 (2020) 'Maternal multimorbidity during pregnancy and after childbirth in women in low- and middle-income countries: a systematic literature review.'. BMC Pregnancy and Childbirth, Vol 20, p. 637.

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Abstract

For every maternal death, 20 to 30 women are estimated to have morbidities related to pregnancy or childbirth. Much of this burden of disease is in women in low- and middle-income countries. Maternal multimorbidity can include physical, psychological and social ill-health. Limited data exist about the associations between these morbidities. In order to address all health needs that women may have when attending for maternity care, it is important to be able to identify all types of morbidities and understand how each morbidity influences other aspects of women's health and wellbeing during pregnancy and after childbirth. We systematically reviewed published literature in English, describing measurement of two or more types of maternal morbidity and/or associations between morbidities during pregnancy or after childbirth for women in low- and middle-income countries. CINAHL plus, Global Health, Medline and Web of Science databases were searched from 2007 to 2018. Outcomes were descriptions, occurrence of all maternal morbidities and associations between these morbidities. Narrative analysis was conducted. Included were 38 papers reporting about 36 studies (71,229 women; 60,911 during pregnancy and 10,318 after childbirth in 17 countries). Most studies (26/36) were cross-sectional surveys. Self-reported physical ill-health was documented in 26 studies, but no standardised data collection tools were used. In total, physical morbidities were included in 28 studies, psychological morbidities in 32 studies and social morbidities in 27 studies with three studies assessing associations between all three types of morbidity and 30 studies assessing associations between two types of morbidity. In four studies, clinical examination and/or basic laboratory investigations were also conducted. Associations between physical and psychological morbidities were reported in four studies and between psychological and social morbidities in six. Domestic violence increased risks of physical ill-health in two studies. There is a lack of standardised, comprehensive and routine measurements and tools to assess the burden of maternal multimorbidity in women during pregnancy and after childbirth. Emerging data suggest significant associations between the different types of morbidity. PROSPERO CRD42018079526.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WA Public Health > Statistics. Surveys > WA 900 Public health statistics WQ Obstetrics > Childbirth. Prenatal Care > WQ 175 Prenatal care WQ Obstetrics > Pregnancy > WQ 200 General works
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1186/s12884-020-03303-1
SWORD Depositor:	JISC Pubrouter
Depositing User:	Stacy Murtagh
Date Deposited:	04 Nov 2020 11:35
Last Modified:	14 Dec 2020 10:46
URI:	https://archive.lstmed.ac.uk/id/eprint/16008

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