Changes in the prevalence of maternal chronic conditions during pregnancy: A nationwide age–period–cohort analysis
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. Sett...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2025-01, Vol.132 (1), p.44-52 |
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| creator | Lundborg, Louise Ananth, Cande V. Joseph, K. S. Cnattingius, Sven Razaz, Neda |
| description | 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.
Linked article: This article is commented on by Merriel p. 53 in this issue. To view this article visit https://doi.org/10.1111/1471‐0528.17959. |
| doi_str_mv | 10.1111/1471-0528.17885 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_872730</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3070827484</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4905-fd55777a639ca3fe4f4a3be8b4365cbb3d9f0d4abd09a07b39265f2b16dd69433</originalsourceid><addsrcrecordid>eNqdkk1v1DAQhiMEoqVw5oYsceGS1h9x7HBB7YpPVeoFzpZjT3ZdsvZiJ7vaG_-Bf8gvwelulxYJIeGLRzPP-8oznqJ4TvApyeeMVIKUmFN5SoSU_EFxfMg8vIlxiRmVR8WTlK4xJjXF7HFxxKRsmoqJ42I9W2g_h4ScR8MC0CrCWvfgDaDQoaUeIHrdI7OIwTuDTPDWDS74hOwYnZ9PgrnX3mxfo3Pk9VTbOAtIz-Hn9x8riC7YHJiwCHFAOpttk0tPi0ed7hM8298nxZd3bz_PPpSXV-8_zs4vS1M1mJed5VwIoWvWGM06qLpKsxZkW7Gam7ZltumwrXRrcaOxaFlDa97RltTW1rlBdlKUO9-0gdXYqlV0Sx23Kmin9qmvOQIlBRUMZ775K7-Kwf4W3Qrp7Sz_Q0u45KShuM7aNzttBpZgDfgh6v6-xb2Kdws1D2tFSE1ojWV2eLV3iOHbCGlQS5cM9L32EMakGBZYUlHJKqMv_0Cvwzh9c6YI4xhTwibDsx1lYkgpQnd4DcFqWj41rZqaVk3dLF9WvLjbxIG_MyG-Azauh-2__NTFp6ud8S-wverC</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3135002138</pqid></control><display><type>article</type><title>Changes in the prevalence of maternal chronic conditions during pregnancy: A nationwide age–period–cohort analysis</title><source>Wiley Online Library - AutoHoldings Journals</source><source>MEDLINE</source><source>SWEPUB Freely available online</source><creator>Lundborg, Louise ; Ananth, Cande V. ; Joseph, K. S. ; Cnattingius, Sven ; Razaz, Neda</creator><creatorcontrib>Lundborg, Louise ; Ananth, Cande V. ; Joseph, K. S. ; Cnattingius, Sven ; Razaz, Neda</creatorcontrib><description>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.
Linked article: This article is commented on by Merriel p. 53 in this issue. To view this article visit https://doi.org/10.1111/1471‐0528.17959.</description><identifier>ISSN: 1470-0328</identifier><identifier>ISSN: 1471-0528</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.17885</identifier><identifier>PMID: 38899437</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Age ; Body mass index ; chronic conditions ; Chronic Disease - epidemiology ; Chronic illnesses ; clinical epidemiology ; Cohort analysis ; Cohort Studies ; Country of birth ; Cross-Sectional Studies ; Fecundity ; Female ; Humans ; Maternal Age ; maternal disease ; Medicin och hälsovetenskap ; Middle Aged ; Obesity ; Obesity - epidemiology ; Population studies ; Pregnancy ; Pregnancy Complications - epidemiology ; pregnancy risk factors ; Prevalence ; Sweden - epidemiology ; Trends ; Womens health ; Young Adult</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2025-01, Vol.132 (1), p.44-52</ispartof><rights>2024 The Author(s). published by John Wiley & Sons Ltd.</rights><rights>2024 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4905-fd55777a639ca3fe4f4a3be8b4365cbb3d9f0d4abd09a07b39265f2b16dd69433</cites><orcidid>0000-0002-2407-2151 ; 0000-0002-0410-2595</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1471-0528.17885$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1471-0528.17885$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38899437$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:158519206$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:238899437$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Lundborg, Louise</creatorcontrib><creatorcontrib>Ananth, Cande V.</creatorcontrib><creatorcontrib>Joseph, K. S.</creatorcontrib><creatorcontrib>Cnattingius, Sven</creatorcontrib><creatorcontrib>Razaz, Neda</creatorcontrib><title>Changes in the prevalence of maternal chronic conditions during pregnancy: A nationwide age–period–cohort analysis</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>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.
Linked article: This article is commented on by Merriel p. 53 in this issue. To view this article visit https://doi.org/10.1111/1471‐0528.17959.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Body mass index</subject><subject>chronic conditions</subject><subject>Chronic Disease - epidemiology</subject><subject>Chronic illnesses</subject><subject>clinical epidemiology</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Country of birth</subject><subject>Cross-Sectional Studies</subject><subject>Fecundity</subject><subject>Female</subject><subject>Humans</subject><subject>Maternal Age</subject><subject>maternal disease</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity - epidemiology</subject><subject>Population studies</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - epidemiology</subject><subject>pregnancy risk factors</subject><subject>Prevalence</subject><subject>Sweden - epidemiology</subject><subject>Trends</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1470-0328</issn><issn>1471-0528</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNqdkk1v1DAQhiMEoqVw5oYsceGS1h9x7HBB7YpPVeoFzpZjT3ZdsvZiJ7vaG_-Bf8gvwelulxYJIeGLRzPP-8oznqJ4TvApyeeMVIKUmFN5SoSU_EFxfMg8vIlxiRmVR8WTlK4xJjXF7HFxxKRsmoqJ42I9W2g_h4ScR8MC0CrCWvfgDaDQoaUeIHrdI7OIwTuDTPDWDS74hOwYnZ9PgrnX3mxfo3Pk9VTbOAtIz-Hn9x8riC7YHJiwCHFAOpttk0tPi0ed7hM8298nxZd3bz_PPpSXV-8_zs4vS1M1mJed5VwIoWvWGM06qLpKsxZkW7Gam7ZltumwrXRrcaOxaFlDa97RltTW1rlBdlKUO9-0gdXYqlV0Sx23Kmin9qmvOQIlBRUMZ775K7-Kwf4W3Qrp7Sz_Q0u45KShuM7aNzttBpZgDfgh6v6-xb2Kdws1D2tFSE1ojWV2eLV3iOHbCGlQS5cM9L32EMakGBZYUlHJKqMv_0Cvwzh9c6YI4xhTwibDsx1lYkgpQnd4DcFqWj41rZqaVk3dLF9WvLjbxIG_MyG-Azauh-2__NTFp6ud8S-wverC</recordid><startdate>202501</startdate><enddate>202501</enddate><creator>Lundborg, Louise</creator><creator>Ananth, Cande V.</creator><creator>Joseph, K. S.</creator><creator>Cnattingius, Sven</creator><creator>Razaz, Neda</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0002-2407-2151</orcidid><orcidid>https://orcid.org/0000-0002-0410-2595</orcidid></search><sort><creationdate>202501</creationdate><title>Changes in the prevalence of maternal chronic conditions during pregnancy: A nationwide age–period–cohort analysis</title><author>Lundborg, Louise ; Ananth, Cande V. ; Joseph, K. S. ; Cnattingius, Sven ; Razaz, Neda</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4905-fd55777a639ca3fe4f4a3be8b4365cbb3d9f0d4abd09a07b39265f2b16dd69433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Body mass index</topic><topic>chronic conditions</topic><topic>Chronic Disease - epidemiology</topic><topic>Chronic illnesses</topic><topic>clinical epidemiology</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Country of birth</topic><topic>Cross-Sectional Studies</topic><topic>Fecundity</topic><topic>Female</topic><topic>Humans</topic><topic>Maternal Age</topic><topic>maternal disease</topic><topic>Medicin och hälsovetenskap</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity - epidemiology</topic><topic>Population studies</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - epidemiology</topic><topic>pregnancy risk factors</topic><topic>Prevalence</topic><topic>Sweden - epidemiology</topic><topic>Trends</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lundborg, Louise</creatorcontrib><creatorcontrib>Ananth, Cande V.</creatorcontrib><creatorcontrib>Joseph, K. S.</creatorcontrib><creatorcontrib>Cnattingius, Sven</creatorcontrib><creatorcontrib>Razaz, Neda</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lundborg, Louise</au><au>Ananth, Cande V.</au><au>Joseph, K. S.</au><au>Cnattingius, Sven</au><au>Razaz, Neda</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in the prevalence of maternal chronic conditions during pregnancy: A nationwide age–period–cohort analysis</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2025-01</date><risdate>2025</risdate><volume>132</volume><issue>1</issue><spage>44</spage><epage>52</epage><pages>44-52</pages><issn>1470-0328</issn><issn>1471-0528</issn><eissn>1471-0528</eissn><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.
Linked article: This article is commented on by Merriel p. 53 in this issue. To view this article visit https://doi.org/10.1111/1471‐0528.17959.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38899437</pmid><doi>10.1111/1471-0528.17885</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2407-2151</orcidid><orcidid>https://orcid.org/0000-0002-0410-2595</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2025-01, Vol.132 (1), p.44-52 |
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| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_872730 |
| source | Wiley Online Library - AutoHoldings Journals; MEDLINE; SWEPUB Freely available online |
| subjects | Adolescent Adult Age Body mass index chronic conditions Chronic Disease - epidemiology Chronic illnesses clinical epidemiology Cohort analysis Cohort Studies Country of birth Cross-Sectional Studies Fecundity Female Humans Maternal Age maternal disease Medicin och hälsovetenskap Middle Aged Obesity Obesity - epidemiology Population studies Pregnancy Pregnancy Complications - epidemiology pregnancy risk factors Prevalence Sweden - epidemiology Trends Womens health Young Adult |
| title | Changes in the prevalence of maternal chronic conditions during pregnancy: A nationwide age–period–cohort analysis |
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