Grant: Project Grant

One in 4 pregnant women have a chronic condition, and chronic illness is one leading cause of severe pregnancy complications and maternal death. Research and practice have largely focused on the effects of an individual chronic condition, whether it be related to physical health (e.g., diabetes) or mental health (e.g., depression). However, our research shows that 1 in 8 pregnant women have co-occurring physical and mental health conditions. Outside of pregnancy, adults with physical-mental multimorbidity are more likely to require hospital care and die prematurely than those with a physical or mental health condition alone. They also experience challenges coordinating their medical and psychiatric care. How physical-mental multimorbidity plays out in pregnancy, however, is unknown in terms of pregnancy outcomes and care. We will use whole-population medical records data in Ontario to examine the impact of physical-mental multimorbidity on risks of pregnancy complications and chronic illness-related emergency department visits and hospital admissions in the perinatal period. We will also use in-depth interviews with women with physical-mental multimorbidity with a pregnancy in the last 5 years, their service-providers, and identified decision-makers to understand pregnancy and postpartum care experiences in this population. Our findings will improve the health care system: A systematic approach to coordinated physical and mental health care in the perinatal period - placing the pregnant person with physical-mental multimorbidity at the centre of care - does not currently exist. Our data will impact health care delivery by providing evidence needed to prioritize health care models that address such multimorbidity. Physical-mental multimorbidity affects 1 in 8 pregnant women. Efforts to improve pregnancy and postpartum care for women with physical-mental multimorbidity will therefore ultimately improve the health of Canadian women and their children.