Changes in the prevalence of maternal chronic conditions during pregnancy: A nationwide age-period-cohort analysis.

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL ACS Applied Energy Materials Pub Date : 2024-06-20 DOI:10.1111/1471-0528.17885

Louise Lundborg, Cande V Ananth, K S Joseph, Sven Cnattingius, Neda Razaz

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Abstract

Objective: To estimate temporal changes in the prevalence of pre-existing chronic conditions among pregnant women in Sweden and evaluate the extent to which secular changes in maternal age, birth cohorts and obesity are associated with these trends.

Design: Population-based cross-sectional study.

Setting: Sweden, 2002-2019.

Population: All women (aged 15-49 years) who delivered in Sweden (2002-2019).

Methods: An age-period-cohort analysis was used to evaluate the effects of age, calendar periods, and birth cohorts on the observed temporal trends.

Main outcome measures: Pre-existing chronic conditions, including 17 disease categories of physical and psychiatric health conditions recorded within 5 years before childbirth, presented as prevalence rates and rate ratios (RRs) with 95% confidence intervals (CIs). Temporal trends were also adjusted for pre-pregnancy body mass index (BMI) and the mother's country of birth.

Results: The overall prevalence of at least one pre-existing chronic condition was 8.7% (147 458 of 1 703 731 women). The rates of pre-existing chronic conditions in pregnancy increased threefold between 2002-2006 and 2016-2019 (RR 2.82, 95% CI 2.77-2.87). Rates of psychiatric (RR 3.80, 95% CI 3.71-3.89), circulatory/metabolic (RR 1.62, 95% CI 1.55-1.71), autoimmune/neurological (RR 1.69, 95% CI 1.61-1.78) and other (RR 2.10, 95% CI 1.99-2.22) conditions increased substantially from 2002-2006 to 2016-2019. However, these increasing rates were less pronounced between 2012-2015 and 2016-2019. No birth cohort effect was evident for any of the pre-existing chronic conditions. Adjusting for secular changes in obesity and the mother's country of birth did not affect these associations.

Conclusions: The burden of pre-existing chronic conditions in pregnancy in Sweden increased from 2002 to 2019. This increase may be associated with the improved reporting of diagnoses and advancements in chronic condition treatment among women, potentially enhancing their fecundity.

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孕期孕产妇慢性病患病率的变化：全国范围内的年龄段队列分析。

目的估计瑞典孕妇既往慢性病患病率的时间变化，并评估孕妇年龄、出生队列和肥胖的世俗变化与这些趋势的关联程度：设计：基于人口的横断面研究：背景：瑞典，2002-2019 年：所有在瑞典分娩的女性（15-49 岁）（2002-2019 年）：方法：采用年龄-时期-队列分析法评估年龄、日历时期和出生队列对观察到的时间趋势的影响：产前慢性病，包括产前 5 年内记录的 17 种疾病类别的身体和精神健康状况，以患病率和比率比 (RR) 以及 95% 置信区间 (CI) 表示。时间趋势还根据孕前体重指数（BMI）和母亲的出生国进行了调整：至少一种孕前慢性病的总体患病率为 8.7%（1 703 731 名妇女中的 147 458 人）。从 2002-2006 年到 2016-2019 年，妊娠期原有慢性病的发病率增加了三倍（RR 2.82，95% CI 2.77-2.87）。精神疾病（RR 3.80，95% CI 3.71-3.89）、循环/代谢疾病（RR 1.62，95% CI 1.55-1.71）、自身免疫/神经疾病（RR 1.69，95% CI 1.61-1.78）和其他疾病（RR 2.10，95% CI 1.99-2.22）的发病率在 2002-2006 年至 2016-2019 年期间大幅上升。然而，在 2012-2015 年至 2016-2019 年期间，这些比率的增长并不明显。任何一种既往慢性病都没有明显的出生队列效应。对肥胖的世代变化和母亲的出生国进行调整也不会影响这些关联：结论：从2002年到2019年，瑞典妊娠期原有慢性疾病的负担有所增加。这一增长可能与妇女诊断报告的改善和慢性病治疗的进步有关，这可能会提高她们的生育能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.