These are some examples of long-term physical or mental health conditions that pre-existed before pregnancy. All long-term health conditions are important. The list is not exhaustive. We apologise if your health condition is not listed here.
Cancers
- All cancers
- Solid cancers
- Haematological cancers
- Metastatic cancers
- Exclude basal cell carcinoma
Cardiovascular disease
- Hypertension
- Ischemic heart disease & Myocardial infarction (heart attack)
- Myocardial infarction (thrombosis)
- Myocardial infarction (dissection)
- Heart failure
- Stroke
- Transient ischemic attack
- Ischemic stroke
- Haemorrhagic stroke
- Unspecified stroke
- Atrial fibrillation
- Congenital heart disease
- Valvular heart disease (mitral, aortic, mixed)
- Congenital
- Acquired (e.g Rheumatic valvular disease)
- Cardiomyopathy
- Congenital
- Acquired
Dermatology
- Eczema
- Psoriasis
- Autoimmune skin disease
- Vitiligo
- Alopecia areata
- Other dermatological conditions
- Seborrheic dermatitis
- Rosacea
- Hidradenitis suppurativa
- Lichen planus
Ear, Nose, Throat
- Profound deafness
- Allergic rhinitis & allergic conjunctivitis
Eye
- Inflammatory eye disease
- Scleritis & episcleritis
- Anterior uveitis
- Posterior uveitis
- Cataract
- Diabetic eye disease
- Severe blindness
- Retinal detachment
Gastroenterology
- Irritable bowel syndrome
- Inflammatory bowel disease
- Ulcerative colitis
- Crohn’s disease
- Coeliac disease
- Chronic liver disease
- Chronic hepatitis B & C
- Alcoholic liver disease
- Autoimmune liver disease
- Cirrhosis
- Non-alcoholic fatty liver disease
- Peptic ulcer
- Gall stones (cholelithiasis)
Gynaecology
- Polycystic ovarian syndrome
- Endometriosis
- Leiomyoma (fibroids)
- Infertility
Haematology
- History of venous thromboembolism (VTE, blood clots)
- Deep vein thrombosis
- Pulmonary embolism
- Other VTE
- Primary thrombocytopenia
- Haemophilia
- Sickle cell anaemia
- Pernicious anaemia
Mental health
- Depression
- Anxiety
- Anxiety
- Panic disorder
- Phobia disorder
- Post traumatic stress disorder
- Serious mental illness
- bipolar affective disorder
- schizophrenia
- psychosis
- Eating disorder
- History of alcohol use disorder (misuse / dependence)
- History of substance misuse
- Others
- Obsessive compulsive disorder (OCD)
- Self-harm
- Personality disorder
- Dissociative disorder
Neurodevelopmental disorders
43. Neurodevelopmental disorder
- Learning disability
- Attention deficit hyperactivity disorder
- Autistic spectrum disorder
Rheumatology
- Systemic lupus erythematosus
- Spondyloarthritis
- Psoriatic arthritis
- Ankylosing spondylitis
- Inflammatory arthritis
- Rheumatoid arthritis
- Sjogern’s syndrome
- Raynaud’s syndrome
- Systemic sclerosis
- Primary systemic vasculitis
- Ehler’s Danlos Syndrome (EDS) Type 3 (Hypermobile EDS)
Orthopaedic
- Scoliosis
- Vertebral disorder
- Intervertebral disc disorder
- Spondylosis
- Spondylolisthesis
- Collapsed vertebrae
- Spinal stenosis
- Chronic back pain
- Osteoporosis
- Osteoarthritis
Neurology
- Migraine
- Other chronic headache (including cluster headache, tension headache, other chronic headache)
- Epilepsy
- Multiple sclerosis
- Spina bifida
- Idiopathic intracranial hypertension
- Peripheral neuropathy
- Other neurological conditions / musculoskeletal disorders
- chronic fatigue syndrome / myalgic encephalomyelitis
- fibromyalgia
- chronic pain syndrome (includes chronic regional pain syndrome, myofascial pain syndrome)
Respiratory
- Asthma
- Chronic obstructive pulmonary disease
- Obstructive sleep apnoea
- Pulmonary fibrosis, interstitial lung disease
- Pulmonary hypertension
- Bronchiectasis
- Cystic fibrosis
- Sarcoidosis
Renal
- Chronic kidney disease
- Urinary tract stones
Endocrine
- Diabetes mellitus
- Thyroid disorder
- Pituitary disorder
- Adrenal benign tumour
- Hyperparathyroidism
Other
- Human immunodeficiency viral (HIV) infection / AIDS
- Turner’s syndrome
- Marfan’s syndrome
- Solid organ transplant
Epidemiological study: Operationalising multiple long-term conditions
Multiple long-term conditions was defined by the presence of two or more pre-existing long-term physical or mental health conditions that were present before pregnancy. Pregnancy related conditions (e.g. gestational diabetes) were not included.
For our epidemiological study, we operationalised multiple long-term conditions in pregnancy using the above list of 79 health conditions.
A list of long-term health conditions was first identified from existing literature, in particular based on the work commissioned by Health Data Research UK on multiple long-term conditions conceptualisation [1], and a recent publication on prevalence of different conditions in the UK [2]. This list and phenome definitions were refined and harmonised through workshops with our research advisory group, consisting of women representatives, clinicians from general practice, obstetrics, maternal medicine, psychiatry, public health, and data scientists. Health conditions were selected on the following basis: (i) prevalence; (ii) impact on pregnancy outcomes; (iii) considered important by women; and (iv) recorded in the study datasets.
References
[1] Ho IS, Azcoaga-Lorenzo A, Akbari A, Black C, Davies J, Hodgins P, Khunti K, Kadam U, Lyons RA, McCowan C, Mercer S, Nirantharakumar K, Guthrie B. Examining variation in the measurement of multimorbidity in research: a systematic review of 566 studies. Lancet Public Health. 2021 Aug;6(8):e587-e597. doi: 10.1016/S2468-2667(21)00107-9. Epub 2021 Jun 22. PMID: 34166630. [2] Kuan V, Denaxas S, Gonzalez-Izquierdo A, Direk K, Bhatti O, Husain S, et al. A chronological map of 308 physical and mental health conditions from 4 million individuals in the English National Health Service. The Lancet Digital health. 2019;1(2):e63-e77. Epub 2019/10/28. doi: 10.1016/s2589-7500(19)30012-3. PubMed PMID: 31650125; PubMed Central PMCID: PMCPMC6798263.Phenome definitions (physical and mental health conditions, active multimorbidity)
Github: For Read codes, ICD-10 codes and phenome definitions
What about gastroenteritis in pregnancy
, can’t it also come under gastroenterology?
Thank you so much for your comment and interest in MuM-PreDiCT.
For the purpose of the study, we look at long-term health conditions that are present before pregnancy. These are conditions that continuously have an impact on a person’s life and may require long-term medical management.
We have not included acute, short-term conditions, such as infections, in the study. These acute, short-term conditions are also very important in pregnancy. It is just that they are not within the scope of our study.
We also have not included conditions or symptoms that arise during pregnancy, such as gestational diabetes, pregnancy associated nausea and vomiting, heart burn or gastroenteritis. This is because these are considered as outcomes (what happened as a consequence of being pregnant with pre-existing long-term conditions).
For example, we want to know if a pregnant woman with 2 or more long-term conditions are more likely to get these pregnancy complications or events. These are some of the research we will be doing and we hope it will provide useful information to women with multiple long-term conditions.
Thank you for your comment, I have updated the blog to reflect that the list of health conditions are not exhaustive and I apologise if there are other long-term conditions that I have not captured in the list.
I hope that answers your query. Thank you once again and I wish you a lovely day.
Yours sincerely,
Siang Ing Lee
Clinical Research Fellow
MuM-PreDiCT