Queen's University Belfast

Academic Institute

Kelly-Ann Eastwood

E062

Multimorbidity is when a person has two or more long-term health problems. It can be difficult for people with several long-term illnesses to manage their conditions. They may have to coordinate appointments with different specialists and their medications need to be managed carefully. Multimorbidity is becoming more common in pregnancy. However, we don't understand why this is and what the consequences are for the pregnancy, the birth of the baby and the mother and baby’s health in the long-term. If we can understand what makes a pregnant woman more likely to have multimorbidity, we can find ways to prevent it and design health services tailored to their specific needs. Our research will look at electronic health records to find out how many women have multimorbidity in pregnancy and what illnesses they have. We will examine if factors such as age, weight or social background influence whether a woman has multimorbidity in pregnancy. We will also find out which illnesses group together (cluster), which clusters are most common. We will then compare what happen to mothers (and their babies) with and without multimorbidity during pregnancy. To begin with, we will focus on preterm birth as an outcome. To understand how medications affect the health of the mother and the baby, we will first find out which medicines women take during different time points of the pregnancy. We will also identify the common combinations of medications which women with multimorbidity take during pregnancy. This knowledge will help doctors prescribe safely during pregnancy.

In utilising existing data held by publicly funded databases, the study is a cost-effective way of using data from key public health resources and answering our research questions using a large and representative population sample. The study findings will indirectly improve patient care by informing public health policy for the care of pregnant women with multimorbidity. With better understanding of the current burden of pre-existing multimorbidity, determinants of multimorbidity status in pregnant women and the effect of multimorbidity status on pregnancy complications (starting with exploration of preterm birth as an outcome), the study findings will highlight the importance of multimorbidity in pregnancy as a public health issue needing further attention. It will also provide suggestions of interventions addressing the determinants of multimorbidity status and allow health services to be targeted towards the characteristics of at risk populations. Similarly, the study finding will improve our understanding on the prescription pattern before, during and after pregnancy, how medications are used in combination during these periods. This will indirectly improve patient care by informing clinical practice guidelines.

19/01/2021

TRE