Multiple Health Conditions Before Pregnancy May Raise Miscarriage Risk by 20%: Lancet Study

Women entering pregnancy with two or more long-term physical or mental health conditions may face a 20% higher risk of miscarriage, according to a large new study published in The Lancet Public Health. The research also found increased risks of several other pregnancy complications, highlighting the importance of managing existing health problems before and during pregnancy.

The findings are based on an analysis of more than 2.2 million pregnancies and birth events recorded between 2000 and 2022 across England, Scotland, Wales and Northern Ireland. The study was led by researchers including King's College London and examined the impact of multiple long-term conditions on pregnancy outcomes.

What Did The Study Find?

According to The Lancet study, the researchers compared pregnancy outcomes among women with multiple long-term conditions with those who had no such conditions.

• Women with two or more pre-existing conditions had:
• 20% higher risk of miscarriage
• 69% higher risk of severe nausea and vomiting
• 42% higher risk of pre-eclampsia
• 26% higher risk of gestational diabetes
• 32% higher risk of placental abruption
• More than double the risk of venous thromboembolism, a potentially serious type of blood clot
• Around four times the risk of antenatal anxiety and depression

The researchers also found that risks increased as the number of health conditions increased.

For women with three or more long-term conditions, the risk of venous thromboembolism was more than three-and-a-half times that of women without long-term conditions.

Also Read: Pregnancy After Miscarriage: Fertility Expert's Guide To Keep In Mind While Planning

What Are Multiple Long-Term Health Conditions?

The study focused on women who had two or more long-term physical or mental health conditions when they entered pregnancy.

• These can include different combinations of chronic physical and mental health problems. The important point is that having several conditions at the same time may create a more complex pregnancy than having a single health condition.

The researchers say maternity care often focuses on individual conditions rather than considering the combined effect of several conditions.

Does Having A Health Condition Mean You Will Have A Miscarriage?

No.

The study shows an association between having multiple long-term conditions and an increased risk of miscarriage. It does not mean that every woman with a chronic health condition will experience pregnancy loss.

Miscarriage has many possible causes, and having a health condition does not automatically mean that a pregnancy will be unsuccessful.

Importance of Pre-Pregnancy Care

Planning a pregnancy can provide an opportunity to review existing health conditions and medicines before conception.

• Women with conditions such as diabetes, thyroid disorders, high blood pressure, or other long-term illnesses may benefit from discussing pregnancy plans with their doctor.
• Treatment can sometimes be adjusted to make it safer and more suitable for pregnancy.
• Pre-conception care can also help doctors identify potential risks and establish a plan for monitoring the mother and baby throughout pregnancy.

Mental health is also part of pregnancy care

One of the notable findings was the increased risk of anxiety and depression.

Women with multiple long-term conditions had almost four times the risk of antenatal anxiety and depression compared with women without long-term conditions.

Living with several health conditions can itself be stressful, while pregnancy can bring additional emotional and physical challenges. Access to appropriate mental health support should therefore be part of comprehensive maternity care.

Also Read: Trimester-by-Trimester Guide: What to Do and What to Avoid for a Safer Pregnancy

What Should Women Do Before Getting Pregnant?

If you have one or more long-term health conditions and are planning a pregnancy, speak to your doctor before trying to conceive. Depending on your medical history, your doctor may review:

• Existing health conditions
• Current medicines
• Blood pressure and blood sugar
• Thyroid function where appropriate
• Weight and nutrition
• Mental health
• Vaccination status
• Previous pregnancy history

Do not stop or change prescribed medicines on your own. Some medicines may need to be changed before pregnancy, while others may be important for keeping an existing condition under control.

Final Word

While the study warns of a potential risk of miscarriage in women with pre-existing medical conditions, it does not mean that women with chronic health conditions should be afraid of pregnancy. For women living with multiple health conditions, discussing pregnancy plans with a healthcare professional before conception can help identify potential risks and ensure that physical and mental health are managed together.