Association of pregnancy complications/risk factors with the development of future long-term health conditions in women: overarching protocol for umbrella reviews

Megha Singh* (Corresponding Author), Francesca Crowe, Shakila Thangaratinam, Kathryn Mary Abel, Mairead Black, Kelvin Okoth, Richard Riley, Kelly-Ann Eastwood, Holly Hope, Steven Wambua, Jemma Healey, Siang Ing Lee, Katherine Phillips, Zoe Vowles, Neil Cockburn, Ngawai Moss, Krishnarajah Nirantharakumar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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INTRODUCTION: With good medical care, most pregnancy complications like pre-eclampsia, gestational diabetes, etc resolve after childbirth. However, pregnancy complications are known to be associated with an increased risk of new long-term health conditions for women later in life, such as cardiovascular disease. These umbrella reviews aim to summarise systematic reviews evaluating the association between pregnancy complications and five groups of long-term health conditions: autoimmune conditions, cancers, functional disorders, mental health conditions and metabolic health conditions (diabetes and hypertension).

METHODS AND ANALYSIS: We will conduct searches in Medline, Embase and the Cochrane database of systematic reviews without any language restrictions. We will include systematic reviews with or without meta-analyses that studied the association between pregnancy complications and the future risk of the five groups of long-term health conditions in women. Pregnancy complications were identified from existing core outcome sets for pregnancy and after consultation with experts. Two reviewers will independently screen the articles. Data will be synthesised with both narrative and quantitative methods. Where a meta-analysis has been carried out, we will report the combined effect size from individual studies. For binary data, pooled ORs with 95% CIs will be presented. For continuous data, we will use the mean difference with 95% CIs. The findings will be presented in forest plots to assess heterogeneity. The methodological quality of the studies will be evaluated with the AMSTAR 2 tool or the Cochrane risk of bias tool. The corrected covered area method will be used to assess the impact of overlap in reviews. The findings will be used to inform the design of prediction models, which will predict the risk of women developing these five group of health conditions following a pregnancy complication.

ETHICS AND DISSEMINATION: No ethical approvals required. Findings will be disseminated through publications in peer-reviewed journals and conference presentations.

Original languageEnglish
Article numbere066476
Number of pages35
JournalBMJ Open
Issue number12
Early online date29 Dec 2022
Publication statusPublished - 29 Dec 2022

Bibliographical note

Patient representatives and MuM-PreDiCT team.

Funding This work was funded by the Strategic Priority Fund 'Tackling multimorbidity at scale' programme (grant number-MR/W014432/1) delivered by the Medical Research Council and the National Institute for Health and Care Research in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council.


  • Pregnancy
  • Female
  • Humans
  • Systematic Reviews as Topic
  • Pregnancy Complications/epidemiology
  • Parturition
  • Pre-Eclampsia/epidemiology
  • Risk Factors
  • Research Design
  • Meta-Analysis as Topic


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