Academic Journal
Pregnancy with multiple high-risk factors: a systematic review and meta-analysis.
| Title: | Pregnancy with multiple high-risk factors: a systematic review and meta-analysis. |
|---|---|
| Authors: | Zhang Y; School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China., Ding W; Health Care Department, Huai'an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, China., Wu T; School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China., Wu S; School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China., Wang H; School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.; Health Care Department, Huai'an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, China., Fawad M; School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China., Adane AA; Ngangk Yira Institute for Change, Murdoch University, Murdoch, Australia.; Telethon Kids Institute, The University of Western Australia, Nedlands, Australia., Dai X; Department of Health Metrics Science, School of Medicine, University of Washington, Seattle, USA.; Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA., Zhu X; Health Care Department, Huai'an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, China., Xu X; School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia. |
| Source: | Journal of global health [J Glob Health] 2025 Feb 07; Vol. 15, pp. 04027. Date of Electronic Publication: 2025 Feb 07. |
| Publication Type: | Journal Article; Systematic Review; Meta-Analysis |
| Language: | English |
| Journal Info: | Publisher: International Society of Global Health Country of Publication: Scotland NLM ID: 101578780 Publication Model: Electronic Cited Medium: Internet ISSN: 2047-2986 (Electronic) Linking ISSN: 20472978 NLM ISO Abbreviation: J Glob Health Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2019>-: Edinburgh : International Society of Global Health Original Publication: Edinburgh : Edinburgh University Global Health Society, 2011- |
| MeSH Terms: | Pregnancy Complications*/epidemiology, Pregnancy Outcome/epidemiology ; Humans ; Pregnancy ; Female ; Risk Factors ; Prevalence |
| Abstract: | Background: A wide spectrum of high-risk factors in pregnancy can lead to adverse pregnancy outcomes or short- or long-term health effects. Despite this, there has been no synthesis of findings on the measurement, potential causes, and health outcomes of multiple high-risk factors in pregnancy (MHFP). We aimed to address this gap by summarising the existing research on this topic. Methods: We retrieved studies published up to 3 June 2024 through systematic database searches and used a narrative synthesis approach to summarise the measurement, patterns, causes, and outcomes of MHFP. We also estimated the pooled MHFP prevalence through meta-analysis with a random effects model and performed subgroup analyses and meta-regression to examine potential sources of between-study heterogeneity. Results: We included 83 observational studies published between 2010 and 2024, of which 72% were from high-income countries. These studied factors can be grouped into four categories: physical conditions, mental conditions, sociobehavioural problems, and pregnancy history. We identified 16 MHFP patterns, among which co-existing multiple physical conditions were the most common pattern. The overall pooled prevalence of MHFP was 12% (95% confidence interval (CI) = 12-13), with an increasing trend and relatively higher levels in low- and middle-income countries (LMICs). We observed heterogeneity in the measurement of MHFP across the studies, possibly due to the number of risk factors in the definition of MHFP. About 78% of included studies investigated MHFP-associated health outcomes for women and offspring, with only two studies examining long-term maternal or offspring outcomes later in life. Conclusions: Research into MHFP has been emerging over the past decade, but is far from complete. The burden of MHFP is increasing worldwide, particularly LMICs. Maternal healthcare systems must shift to a multidisciplinary and integrated framework so as to better design and implement prevention and intervention programmes and sustain the healthy development of the next generation. Registration: PROSPERO: CRD42022358889. (Copyright © 2025 by the Journal of Global Health. All rights reserved.) |
| Competing Interests: | Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests. |
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| Entry Date(s): | Date Created: 20250206 Date Completed: 20250206 Latest Revision: 20260924 |
| Update Code: | 20260924 |
| PubMed Central ID: | PMC11893144 |
| DOI: | 10.7189/jogh.15.04027 |
| PMID: | 39913559 |
| Database: | MEDLINE |
| ISSN: | 2047-2986 |
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| DOI: | 10.7189/jogh.15.04027 |