- Open Access
Non-communicable diseases and maternal health: a scoping review
BMC Pregnancy and Childbirth volume 22, Article number: 787 (2022)
Non-communicable diseases [NCDs] are leading causes of ill health among women of reproductive age and an increasingly important cause of maternal morbidity and mortality worldwide. Reliable data on NCDs is necessary for accurate measurement and response. However, inconsistent definitions of NCDs make reliable data collection challenging. We aimed to map the current global literature to understand how NCDs are defined, operationalized and discussed during pregnancy, childbirth and the postnatal period.
For this scoping review, we conducted a comprehensive global literature search for NCDs and maternal health covering the years 2000 to 2020 in eleven electronic databases, five regional WHO databases and an exhaustive grey literature search without language restrictions. We used a charting approach to synthesize and interpret the data.
Only seven of the 172 included sources defined NCDs. NCDs are often defined as chronic but with varying temporality. There is a broad spectrum of conditions that is included under NCDs including pregnancy-specific conditions and infectious diseases. The most commonly included conditions are hypertension, diabetes, epilepsy, asthma, mental health conditions and malignancy. Most publications are from academic institutions in high-income countries [HICs] and focus on the pre-conception period and pregnancy. Publications from HICs discuss NCDs in the context of pre-conception care, medications, contraception, health disparities and quality of care. In contrast, publications focused on low- and middle-income countries discuss NCDs in the context of NCD prevention. They take a life cycle approach and advocate for integration of NCD and maternal health services.
Standardising the definition and improving the articulation of care for NCDs in the maternal health setting would help to improve data collection and facilitate monitoring. It would inform the development of improved care for NCDs at the intersection with maternal health as well as through a woman's life course. Such an approach could lead to significant policy and programmatic changes with the potential corresponding impact on resource allocation.
Globally, non-communicable diseases (NCDs) are the leading cause of death and disability in women, including in women of reproductive age . The Sustainable Development agenda includes specific targets on both maternal health and NCDs. Sustainable Development Goal (SDG) Target 3.1 calls for a reduction of the global maternal mortality ratio to 70 deaths per 100,000 livebirths; and SDG 3.4 calls to reduce by one-third premature mortality from NCDs . Given the growing prevalence of NCDs worldwide, the Global Strategy for Women’s, Children’s and Adolescents’ Health [2016–2030], a roadmap on ending all preventable deaths in women, integrated NCDs into the Sexual Reproductive Maternal Neonatal Child Adolescent Health (SRMNCAH) response and included a target addressing NCDs as an essential component of the Survive pillar .
Evidence of the burden of non-communicable diseases in maternal health can be found in the 2014 systematic analysis of the global causes of maternal deaths . Maternal deaths are divided into direct (obstetric-related) and indirect causes by the International Classification of Diseases (ICD) . Deaths due to NCDs are considered amongst the fraction of “indirect” maternal deaths. The 2014 analysis found that indirect causes contributed to the same proportion [27%] of maternal deaths as hemorrhage and a higher proportion than hypertensive disorders, which account for the majority of obstetric-related deaths . Yet the approach to NCDs in pregnancy is not well articulated in the maternal health literature. The SRMNCAH continuum of care, especially pregnancy, offers critical entry points for women who may not otherwise access healthcare services. Pregnancy and the postnatal period provide crucial opportunities to integrate NCD services which would allow for early prevention, identification and management. Integrated care of NCDs in pregnancy also has the potential to improve fetal/newborn outcomes and positively impact the overall health and wellbeing for the pregnant woman, her family, and community.
In order to develop interventions that can improve the quality of care and reach of service delivery, reliable data on NCDs in pregnancy is critical. However, there is questionable reliability of the data, especially from low resource settings. Data is limited and there are large variations in the reported prevalence of NCDs in pregnancy. Prevalence data is often generated from hospital-based studies and in low resource settings, where women often cannot reach health facilities, and where health facility birth rates can be low, hospital studies are likely to underestimate the burden of disease. Although the measurement of NCDs in pregnancy is beyond the scope of this paper, inaccurate estimates of the burden of NCDs in pregnancy may result in inefficient research, prioritization and focus in this area of intersection.
A key challenge is that the data are subject to inconsistent definitions of NCDs as a standardized definition is lacking. A wide spectrum of conditions such as medical conditions, malignancies and mental health conditions with varying temporality from acute to chronic have been included under the umbrella of NCDs. It is necessary to arrive at a common understanding of NCDs for accurate and routine measurement of NCDs in order to inform policy decisions, resource allocation and ultimately to launch an appropriate programmatic response to reduce maternal morbidity and mortality.
As a first step towards this process, we undertook a scoping review to map the current literature to understand how NCDs are defined, operationalized and discussed specifically during pregnancy, childbirth and the postnatal period. We also sought to describe the disease conditions that are included within the umbrella of NCDs. Finally, we aimed to identify partners, programs and organizations working in the area of NCDs and maternal health.
The scoping review was conducted using the framework outlined by the Joanna Briggs Institute (https://jbi.global/scoping-review-network/resources#) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews statement (Table S1) [6, 7]. The protocol was registered in Open Science Framework (https://archive.org/details/osf-registrations-trvzf-v1).
A literature search was conducted in African Index Medicus, Africa Wide Information, CINAHL, CKNI, Cochrane Library, Ovid Embase, Google Scholar, IMEMR [Index Medicus for Eastern Mediterriean Region], IMSEAR [Index Medicus for the South-East Asia Region], LILACS [Latin America and the Caribbean Literature on Health Sciences], Ovid Medline, PubMed, PsycInfo, Scopus, Web of Science Core Collection, and WPRIM [Western Pacific Region Index Medicus] to identify papers between 2000–2020 using a combination of controlled vocabulary and keywords for “non-communicable diseases” and “maternal health”. The year 2000 was chosen as the start date as the Millennium Development Goals (MDG) were introduced that year and specifically included a target on maternal mortality, drawing global attention to maternal health . Databases were last searched on November 12, 2020. The search strategies for all databases are outlined in Table S2. A grey literature search was conducted in Google and websites of relevant organizations working in the area of NCDs and maternal health. We hand searched references of included systematic reviews. There were no language restrictions used in this study. As this was a global search, relevant data from all countries were included.
Studies were included if they focused on the population of interest which included reproductive age, pregnant or postpartum women and discussed specific disease conditions within the context of maternal health care provision. Studies of reproductive age women were included if they had implications for pregnancy care. We included studies that provided original data [e.g. observational studies, randomized controlled trials] as well as narrative reviews, commentaries, white papers, policy documents, professional society position statements, blog posts and information from websites of relevant organizations.
We excluded studies that simply provided enumeration of NCDs, focused on placental, fetal or neonatal outcomes, or on long-term consequences of NCDs and those that only reported on adverse pregnancy outcomes in women with NCDs. Studies were also excluded if they were protocols of studies without results.
Citations from all databases were imported in an Endnote × 9 library (Clarivate Analytics, Philadelphia, PA). After removing duplicates using the Yale Reference Deduplicator, the remaining set of articles was imported into Covidence (https://www.covidence.org), a screening and data extraction tool. Two authors independently screened the titles [AG and TF] and abstracts to determine which studies would undergo full-text review [BP, DC, TF and NN]. The full text of the resulting papers was then reviewed for inclusion by two authors independently [BP, DC, TF and NN]. In both screenings, discrepancies were resolved by discussion between BP, DC, and TF. Data extraction was conducted using a standardized data abstraction sheet which was pilot tested by TF and BP and revised to ensure consistency in data abstraction. We extracted data on study type, country of publication, publishing institution(s), target population, definition of NCDs, disease conditions and main findings of the source. Countries were classified using the World Bank Country and Lending Groups (https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups). We classified lower middle and low income economies as “low resource settings”. Data was extracted by at least one of the study members [BP, NN and TF] and reviewed by a second member [DC] also in Covidence.
We aimed to synthesize a thematic framework of maternal health care provisions for NCDs and used a charting approach to synthesize and interpret the data. This technique involved the creation of a ‘data charting form’ using the database program Excel where information about the studies and outcomes was recorded and organized according to key issues and themes relevant to NCDs and maternal health.
A total of 30,199 papers were identified in the databases. After deduplication, 9,445 articles underwent initial screening by title and abstract, 553 had a full text evaluation, and a total of 115 peer-reviewed papers met all of the criteria for inclusion in this review (Fig. 1).
An additional 41 peer-reviewed papers were identified through citation chasing and one peer-reviewer paper was identified during the gray literature search. Fifteen online sources were included from the grey literature search, 14 of which were blog posts and one was an online newspaper article. There were a total of 172 included records [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180]. Almost half (n = 76) of the peer-reviewed publications were cohort and cross-sectional studies. We identified six systematic reviews,Footnote 1 14 qualitative studies, and 23 narrative reviews. The remaining 38 peer reviewed publications were mixed methods studies, descriptive studies, population census, secondary reports of maternal death reviews, editorials/commentaries, professional society position statements, workshop or working group reports. Figure 2 shows the publications by study type.
Three of the peer reviewed publications were global in nature. Of the remaining 148 peer reviewed publications, 85.8% [n = 127] were from high-income countries [HICs], 10.1% [n = 15] from upper middle-income countries and only 4.1% [n = 6] from low resource settings (Fig. 3). 71.6% [n = 106] of the peer-reviewed publications was from Europe and Northern America. 13 publications were from Oceania and 10 were from Latin America and the Caribbean. There were only 16 publications in total from the remaining SDG regions [Sub Saharan Africa, Central and Southern Asia and Eastern and South-Eastern Asia, Eastern and South-Eastern Asia and Northern Africa and Western Asia].
Many papers had authors from one region and concentrated on a population in a different region. About 15% of the peer-reviewed papers and grey literature sources concentrated specifically on populations in low resource settings. Two thirds of the peer reviewed papers focusing on low resource settings were from Europe and Northern America. Only eight of the peer reviewed publications focusing on populations in low resource settings were based on primary data [53, 88, 102, 116, 118, 131, 147, 156], with half published by HIC authors and the other half published by authors from low resource settings. Of the 15 peer reviewed publications that had a global focus, 80% were from Europe and Northern America and mainly discussed health care policy, particularly NCD prevention and service integration.
Institutions and organizations
84.1% [n = 127] of peer-reviewed papers were published by academic institutions. 71.7% [n = 91] of these publications were from Europe and Northern America. Publications from civil societies, governmental organizations, inter-governmental organizations, and private institutions accounted for 9.9% [n = 15] of the publications. 6.6% [n = 10] were joint publications by more than one type of institution or organization. 43% of the blog posts were published by the Maternal Health Task Force, which is an US-based organization. Other organizations publishing blog posts on NCDs in maternal health include the NCD Alliance, Women Deliver, the Wilson Center and Ending Eclampsia.
Target population Footnote 2
About half [51%] of the peer-reviewed publications focused on pregnant women. A similar proportion of papers [50.3%] focused on pre-conception care and reproductive age women while only about a third of papers [35.8%] focused on postpartum women (Fig. 4). Grey literature sources often had more than one population of focus. All the grey literature sources focused on pregnant women with 43% also focusing on reproductive age women and only 25% focusing on postpartum women.
Only three of the peer-reviewed papers [25, 63, 161] and four of the blog posts [168, 169, 177, 180] contained a definition of NCDs. Often, NCDs were mostly discussed as “chronic illness”, “chronic disease” or “chronic medical problems”. One paper described NCDs as “chronic manageable” versus “long-term life-threatening conditions” Table 1 outlines the definitions of NCDs in the available maternal health literature.
Spectrum of NCDs
A wide spectrum of conditions was included under the umbrella of NCDs. The most common conditions were hypertension [46.3%, n = 77 sourcesFootnote 3], diabetes [74.1%, n = 123 sources], obesity [15%, n = 25 sources], mental health conditions [39.8%, n = 66 sources], malignancy [22.9%, n = 38 sources], epilepsy [21.1%, n = 35 sources] and asthma [23.5%, n = 39 sources]. Table S3 outlines conditions by organ system. The commonly included malignancies were breast and cervical cancer. The most common mental health conditions were depression and anxiety. There was a broad spectrum of mental health conditions in the literature but at the same time, several papers did not define mental health conditions. Although by definition, the following conditions are infectious diseases; they were considered in papers due to their chronic nature and other non-infectious sequelae: human immunodeficiency virus (HIV)human papilloma virus (HPV), herpes simplex virus, tuberculosis, schistosomiasis and malaria.
Papers also included pregnancy-specific conditions such as pre-eclampsia, gestational diabetes, peripartum cardiomyopathy, obstetric fistula and postpartum depression as NCDs. The most commonly mentioned risk factors for NCDs included smoking, alcohol consumption, and diet/nutrition.
Thematic areas of NCDs
Table 2 describes the main thematic areas.
Papers discussing NCDs in HICs predominantly focused on specific disease conditions such as hypertension, diabetes, epilepsy, malignancy, and mental health. These publications had a large focus on the pre-conception care of these conditions. These disease conditions were also commonly discussed in the context of medication and contraception usage, quality of care, women’s experiences and health care disparities. There were three papers from HICs focused on the pre-conception care of women over 40 , post-menopausal women  and those undergoing in vitro fertilization .
Publications that discussed NCDs in the context of low resource settings or with a global focus, were mainly driven by civil society, professional organizations and intergovernmental organizations. In contrast to papers focused on NCDs in HICs, these publications took a life course approach and often focused on prevention and screening of NCDs such as hypertension, diabetes and cervical cancer. These publications had a large focus on areas for action on health systems and policy, specifically advocating for the integration of SRMNCAH and NCD services. Some examples include using pre-natal clinics as “good entry points” for breast and cervical cancer screening, integrating cervical cancer screening into HIV clinics and targeting adolescents to deliver HPV vaccines.
In HIC settings, maternal mental health, such as antepartum and postpartum depression and anxiety, was often discussed in the context of other co-morbid conditions. Most publications looked at the association between medical conditions such as hypertension, diabetes, epilepsy and mental health conditions. Maternal mental health was also discussed in the context of substance use disorder and gender-based violence. Publications on maternal mental health with a global or LMIC focus were much more limited. These publications highlighted the impact of mental health conditions of maternal and perinatal outcomes and discussed the need for effective preventative and treatment strategies.
There were no studies with focus on low resource settings or a global focus that discussed women’s experiences of NCDs. There was only one study from Myanmar that looked at pregnant women’s knowledge of NCDs such as hypertension, diabetes, anemia, and nutritional needs during pregnancy . On the other hand, there were publications with HIC focus that looked at pregnant women’s experiences of NCDs such as epilepsy, diabetes, chronic kidney disease, lupus and HIV and quality of life in pregnant women with rheumatic diseases and HIV. Two papers also examined the pregnancy experiences of women with disabilities [98, 154] Publications from HICs also looked at the knowledge and attitudes of reproductive age women with NCDs such as hypertension and diabetes towards pregnancy and pre-conception health as well as their experiences with reproductive health services.
Eighteen papers examined NCDs in the context of healthcare disparities. Fourteen of these papers were from the US [10, 11, 16, 21, 32, 40, 55, 56, 97, 105, 107, 119, 140, 150], two papers from Australia [54, 57] one paper each from Brazil  and India . One of the papers was published by the Centers for Disease Control and Prevention (CDC) from the US in collaboration with the Ministry of Health in Brazil and Pan Americana Health Organization (PAHO) and looked at the association between factors like race, education and insurance status in Brazilian reproductive age women . The rest of the US-based papers focused on a wide range of topics including disparities in insurance coverage, mental health service utilization, chronic disease risk factors, hospitalization in pregnant women with NCDs, medication discontinuation and sexual orientation and health care access. The two papers from Australia focused on Aboriginal women with one paper looking at pre-conception care and the other paper reporting on stakeholder input on health service planning for reproductive age Aboriginal women with NCD risk factors [54, 57]. The paper from Brazil, an upper middle income country, examined inequities in NCD indicators in reproductive age women who were beneficiaries of a government-based social welfare program . The only paper from an LMIC setting was from India which looked at healthcare disparities in the context of out-of-pocket expenditure for the treatment of NCDs in women without insurance .
Our scoping review found that NCDs are not well defined in the maternal health literature. We found a limited number of studies and online sources that defined NCDs. While most defined NCDs as chronic conditions, there was variation in the time period associated with pregnancy. A wide range of conditions were considered to be NCDs including certain infectious diseases and pregnancy-specific conditions. Papers were predominantly from HICs and focused on pre-conception care and pregnancy with few papers focusing on postpartum care. We found that the approach to NCDs differed between HICs and low resource settings. Publications from HIC discussed NCDs in the context of medications, contraception, healthcare disparities, women’s experiences and quality of care. In contrast, publications focused on low resource settings discussed NCDs in the context of NCD prevention including in adolescents and many advocated for the integration of NCD and maternal health services.
Our findings confirm that there is no common definition or framework for NCDs in pregnancy. The wide range of conditions that are categorized as NCDs poses additional challenges to accurate measurement and impacts the quality of prevalence and incidence data. This has also been seen with mortality data as the 2014 systematic analysis of the global causes of maternal deaths described the phenomenon of misattribution and misclassification of maternal deaths, resulting in an underestimation of 20–90% of causes underlying maternal deaths across different settings . While maternal mortality remains a global priority, maternal deaths have been described as the tip of the iceberg and maternal morbidity as the base . The proportion of deaths due to NCDs in women aged 15–49 years has increased from 41% in 2008 to 51% in 2017 . The pilot study conducted by the Maternal Morbidity Working Group found that medical problems had similar levels of prevalence as obstetric ones in pregnant women, and accounted for the majority of postpartum diagnoses, especially in Jamaica and Kenya . One of the key findings of the group was that there is a lack of publications on maternal morbidity due to NCDs in the postpartum period, both in HICs and low resource settings.
A series of papers that mapped the global research agenda for maternal health found that research priorities in maternal health, especially in southern Asia and Sub Saharan Africa are not clearly aligned even with the main causes of obstetric deaths such as hemorrhage and hypertensive disorders of pregnancy . Similarly, we found that despite NCDs being a major contributor of maternal death in low resource settings, few publications addressed NCDs and maternal health. Globally, pre-existing medical conditions accounted for almost 30% of maternal deaths in southern Asia and Sub Saharan Africa  yet we found only a handful of papers from these regions in our scoping review. In addition, many papers focused on low resource settings were written by authors based in HICs, highlighting the need to support local research infrastructure within low resource settings.
In our scoping review we found that the approach to NCD care during pregnancy differs between low resource settings and HICs. While papers with a global or low resource focus discussed NCDs in the context of health systems and service delivery and took a horizontal approach, papers with HIC focus took a vertical disease-based approach. Papers and blog posts focusing on low resource settings discussed the need for an integrated, comprehensive approach to maternal health across the life cycle. A 2017 comparative analysis of integrated care in HICs versus low resource settings found that in low resource settings, the focus has been more on developing specific clusters of services, communicable disease programs, or services for specific patient groups such as pregnant women, while integration in HICs focuses on better management of a broader group of people with multiple morbidities and/or with complex health needs with a focus on altering the wider system such as governance and financing .
In both settings, the epidemiology of maternal health is changing as there is a rising proportion of pregnant women with NCDs and many of these women often have multiple complex medical problems . Maternal health is intimately and reciprocally linked to NCDs. Pre-existing conditions can increase both maternal morbidity and mortality while complications of pregnancy can increase the prevalence of chronic health conditions, influencing not only future pregnancies but also the long-term health of women. Although there are differing approaches to integrated care in HICs and low resource settings, a commonality is that maternal health is viewed separately from the overall general health of a woman. From a health systems perspective, a recognition of the linkages between NCDs and maternal health will facilitate integration of services. The rich body of research on integrated SRH and HIV programming over the last decade may provide insights on how to best implement such services. Furthermore, achieving seamless transitions of care between maternity services and primary care puts into action the concept of care through a woman’s life. Reframing the narrow focus of maternal health from obstetrical care moves maternal health from surviving (pregnancy) to thriving so that the health, well-being, and potential of women throughout their lives can be maximized.
Our scoping review emphasizes the need to bring a lens of equity to the intersection of NCDs and maternal health. We found a stark difference in equity research between HICs and low resource settings, with only two papers from low resource settings that looked at women’s experiences and healthcare disparities. A mapping analysis of the broader maternal health literature found that scant attention was placed on equity research in low resource settings . Similar to our findings, the analysis found that publications from HICs targeted vulnerable groups such as ethnic minorities and people living in poverty, but there was a lack of such research in low resource settings. More research on equity is needed especially in low resource settings to build an evidence-based case for Universal Health Coverage (UHC), which is an essential component of social protection for women. Women with chronic conditions undoubtedly experience financial hardship due to the cost of health care. One of the papers from India included in our review found that the overall medical and non-medical expenses of non–communicable disease are much higher than those of other reproductive health related and communicable diseases and disabilities . These findings underscore the importance of achieving UHC for maternity care, as detailed within EPMM [Ending Preventable Maternal Mortality] strategies to reduce maternal morbidity and mortality and as a critical component to improving the health of women with NCDs .
Strengths and limitations
The main strength of our scoping review is that we conducted a comprehensive literature search of peer-reviewed papers and grey literature without language restrictions. While this is a vast subject area with sparse data, we attempted to characterize NCDs in the context of pregnancy care. We were able to synthesize a large body of work to develop a framework of how NCDs are currently defined, discussed and approached across a variety of settings. Our review highlights the limitations and gaps in the maternal heath literature which has research, programmatic, health care funding and policy implications.
NCDs and their time frames are not well defined in the maternal health literature. As NCDs are a significant contributor to maternal morbidity and mortality, it is important to have a common understanding of NCDs for accurate measurement and surveillance and for quantification of health outcomes. This scoping review highlights the need for a broader approach to maternal health that addresses the changing epidemiology of maternal morbidity and mortality.
A paradigm shift is needed to view pregnancy within a continuum rather than as an isolated event in a woman’s life. There are multiple links between NCDs and the SRMNCAH continuum and there are significant opportunities to leverage solutions by breaking down disciplinary silos. By widening the scope of maternal health services to include NCDs as a part of pregnancy care, continuity in care and the transition from maternity care to primary care services after delivery is critical. This has profound implications for health systems and the provision of services will necessarily need to be contextualized by setting and resource availability. An integrated approach to NCDs in maternal health, however, could be an effective approach to inform the development of programs including priority setting, health policies and funding.
Our paper serves as the background for a program of work in the area of NCDs and maternal health. It will serve as a springboard for the development of guidelines on the management of NCDs in pregnancy and ultimately, identifying specific interventions for health systems.
Availability of data and materials
All data are within the manuscript and additional files however, additional data related to this project is available on Open Science Framework (https://archive.org/details/osf-registrations-trvzf-v1).
Systematic reviews were not included in the analyses below as we used the original studies identified through handsearching the references of the systematic reviews in these analyses. A total of 152 peer reviewed publications are included in the analyses.
Many papers had more than 1 target population. Therefore, numbers will not add up to 100%.
Sources = peer reviewed publications and grey literature.
Centers for Disease Control and Prevention
Ending Preventable Maternal Mortality
High income countries
Human Immunodeficiency Virus
Human Papilloma Virus
Herpes Simplex Virus
International Classification of Diseases
Index Medicus for Eastern Mediterriean Region
Index Medicus for the South-East Asia Region
Latin America and the Caribbean Literature on Health Sciences
Pan Americana Health Organization
Sustainable Development Goal
Sexual Reproductive Maternal Neonatal Child Adolescent Health
Universal Health Coverage
Western Pacific Region Index Medicus
World Health Organization. Global Health Estimates 2019: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2019. Geneva: World Health Organization; 2020. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates. Accessed 3 Jan 2022.
United Nations. The 17 Goals. https://sdgs.un.org/goals. Accessed 3 Jan 2022.
Global Strategy for Women’s. Children’s and Adolescents’ Health (2016–2030). New York: Every Woman Every Child; 2015.
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.
World Health Organization. The WHO application of ICD-10 to deaths during pregnancy, childbirth and puerperium: ICD MM. 2012. https://www.who.int/reproductivehealth/publications/monitoring/9789241548458/en/. Accessed 3 Jan 2022.
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. https://synthesismanual.jbi.global. Accessed 11 Dec 2020.
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, Straus S. E: PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73.
World Health Organization. Millennium Development Goals. https://www.who.int/news-room/fact-sheets/detail/millennium-development-goals-(mdgs). Accessed 28 Feb 2022.
Ackerman IN, Jordan JE, Van Doornum S, Ricardo M, Briggs AM. Understanding the information needs of women with rheumatoid arthritis concerning pregnancy, post-natal care and early parenting: A mixed-methods study. BMC Musculoskelet Disord. 2015;16:194.
Admon LK, Winkelman TNA, Moniz MH, Davis MM, Heisler M, Dalton VK. Disparities in chronic conditions among women hospitalized for delivery in the United States, 2005–2014. Obstet Gynecol. 2017;130(6):1319–26.
Amparo P, Farr SL, Dietz PM. Chronic Disease Risk Factors Among American Indian/Alaska Native Women of Reproductive Age. Prev Chronic Dis. 2011;8(6):10.
American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 736 Summary: Optimizing Postpartum Care. Obstetrics and Gynecology. 2018;131(5):949–51.
Azenha GS, Parsons-Perez C, Goltz S, Bhadelia A, Durstine A, Knaul F, Torode J, Starrs A, McGuire H, Kidwell JD, et al. Recommendations towards an integrated, life-course approach to women’s health in the post-2015 agenda. Bull World Health Organ. 2013;91(9):704–6.
Bachmann GA, Sharma S. Pregnancy counseling for post-menopausal women. Menopause. 2016;23(12):1392.
Beeson JG, Homer CSE, Morgan C, Menendez C. Multiple morbidities in pregnancy: Time for research, innovation, and action. PLoS Med. 2018;15(9):e1002665.
Bennett WL, Chang HY, Levine DM, Wang L, Neale D, Werner E, Clark JM. Predictors of postpartum primary care utilization forwomenwith medically complicated pregnancies: An analysis of medical claims data. J Gen Int Med. 2013;1:S152.
Benute GRG, Nomura RMY, Reis JS, Junior RF, de Lucia MCS, Zugaib M. Depression during pregnancy in women with a medical disorder: Risk factors and perinatal outcomes. Clinics (Sao Paulo, Brazil). 2010;65(11):1127–31.
Berg M. Pregnancy and diabetes: how women handle the challenges. J Perinat Educ. 2005;14(3):23–32.
Bernal RTI, Felisbino-Mendes MS. Carvalho QHd, Pell J, Dundas R, Leyland A, Barreto ML, Malta DC: Indicadores de doenças crônicas não transmíssiveis em mulheres com idade reprodutiva, beneficiárias e não beneficiárias do Programa Bolsa Família. Rev bras epidemiol. 2019;22(supl.2):E190012.190012-E190012.SUPL.19.
Biermann J, Dunlop AL, Brady C, Dubin C, Brann A Jr. Promising practices in preconception care for women at risk for poor health and pregnancy outcomes. Matern Child Health J. 2006;10(1):21–8.
Bronstein JM, Felix HC, Bursac Z, Stewart MK, Foushee HR, Klapow J. Providing General and Preconception Health Care to Low Income Women in Family Planning Settings: Perception of Providers and Clients. Matern Child Health J. 2012;16(2):346–54.
Brooten D, Youngblut JAM, Brown L, Finkler SA, Neff DF, Madigan E. A randomized trial of nurse specialist home care for women with high-risk pregnancies: Outcomes and costs. AJMC. 2001;7(8):793–803.
Broussard DL, Sappenfield WB, Fussman C, Kroelinger CD, Grigorescu V. Core State Preconception Health Indicators: A Voluntary, Multi-state Selection Process. Matern Child Health J. 2011;15(2):158–68.
Brown HK, Qazilbash A, Rahim N, Dennis CL, Vigod SN. Chronic medical conditions and peripartum mental illness: A systematic review and meta-analysis. Am J Epidemiol. 2018;187(9):2060–8.
Brown HK, Wilton AS, Ray JG, Dennis CL, Guttmann A, Vigod SN. Chronic physical conditions and risk for perinatal mental illness: A population-based retrospective cohort study. PLoS Medicine / Public Library of Science. 2019;16(8):e1002864.
Bustreo F, Chestnov O, Knaul FM. Araujo de Carvalho I, Merialdi M, Temmerman M, Beard JR: At the crossroads: Transforming health systems to address women’s health across the life course. Bull World Health Organ. 2013;91(9):622.
Cardona Perez A, Cortes Bonilla M, Velazquez Ramirez N, Diaz Jimenez MJ, Varela Chavez Y, Figueroa Damian R. Project of preventive care of women with high reproductive risk. Perinatologia y Reproduccion Humana. 2017;31(2):96–104.
Certain HE, Mueller M, Jagodzinski T, Fleming M. Domestic abuse during the previous year in a sample of postpartum women. J Obstet Gynecol Neonatal Nurs. 2008;37(1):35–41.
Chaaya M, Campbell OM, El Kak F, Shaar D, Harb H, Kaddour A. Postpartum depression: prevalence and determinants in Lebanon. Arch Womens Ment Health. 2002;5(2):65–72.
Champaloux SW, Tepper NK, Curtis KM, Zapata LB, Whiteman MK, Marchbanks PA, Jamieson DJ. Contraceptive use among women with medical conditions in a nationwide privately insured population. Obstet Gynecol. 2015;126(6):1151–9.
Chandranipapongse W, Koren G. Preconception counseling for preventable risks. Can Fam Physician. 2013;59(7):737–9.
Chatterjee S, Kotelchuck M, Sambamoorthi U. Prevalence of Chronic Illness in Pregnancy, Access to Care, and Health Care Costs Implications for Interconception Care. Women’s Health Issues. 2008;18(6 SUPPL):S107–16.
Chuang CH, Chang PJ, Hsieh WS, Tsai YJ, Lin SJ, Chen PC. Chinese herbal medicine use in Taiwan during pregnancy and the postpartum period: A population-based cohort study. Int J Nurs Stud. 2009;46(6):787–95.
Chuang CH, Velott DL, Weisman CS. Exploring knowledge and attitudes related to pregnancy and preconception health in women with chronic medical conditions. Matern Child Health J. 2010;14(5):713–9.
Clouse K, Motlhatlhedi M, Bonnet K, Schlundt D, Aronoff DM, Chakkalakal R, Norris SA. “I just wish that everything is in one place”: facilitators and barriers to continuity of care among HIV-positive, postpartum women with a non-communicable disease in South Africa. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2018;30(Supplement 2):5–10.
Cohen MM, Schei B, Ansara D, Gallop R, Stuckless N, Stewart DE. A history of personal violence and postpartum depression: is there a link? Arch Womens Ment Health. 2002;4(3):83–92.
Collins JL, Lehnherr J, Posner SF, Toomey KE. Ties that bind: maternal and child health and chronic disease prevention at the Centers for Disease Control and Prevention. Prev Chronic Dis. 2009;6(1):A01.
Cui Y, Shooshtari S, Forget EL, Clara I, Cheung KF. Smoking during Pregnancy: Findings from the 2009–2010 Canadian Community Health Survey. PLoS One. 2014;9(1):5.
Cunningham SD, Herrera C, Udo IE, Kozhimannil KB, Barrette E, Magriples U, Ickovics JR. Maternal Medical Complexity: Impact on Prenatal Health Care Spending among Women at Low Risk for Cesarean Section. Womens Health Issues. 2017;27(5):551–8.
Cunningham SD, Riis V, Line L, Patti M, Bucher M, Durnwald C, Srinivas SK. Safe Start Community Health Worker Program: A Multisector Partnership to Improve Perinatal Outcomes Among Low-Income Pregnant Women With Chronic Health Conditions. Am J Public Health. 2020;110(6):836–9.
DeCesare JZ, Jackson JR, Phillips B. Interconception care opportunities for mom and baby. Obstet Gynecol Surv. 2015;70(7):465–72.
Diabetes and Pregnancy Group. Knowledge about preconception care in French women with type 1 diabetes. Diabetes Metab. 2005;31(5):443–7.
Dietl A, Cupisti S, Beckmann MW, Schwab M, Zollner U. Pregnancy and Obstetrical Outcomes in Women over 40 Years of Age. Geburtshilfe Frauenheilkd. 2015;75(8):827–32.
Dunlop AL, Logue KM, Thorne C, Badal HJ. Change in women’s knowledge of general and personal preconception health risks following targeted brief counseling in publicly funded primary care settings. (Supplemental Issue: Effective strategies for promoting preconception health - from research to pr. Am J Health Promot. 2013;27(3 Suppl):S50–7.
El-Ibiary SY, Raney EC, Moos MK. The pharmacist’s role in promoting preconception health. J Am Pharm Assoc. 2014;54(5):e288–303.
Farahi N, Zolotor A. Recommendations for preconception counseling and care. Am Fam Physician. 2013;88(8):499–506.
Farr SL, Dietz PM, O’Hara MW, Burley K, Ko JY. Postpartum anxiety and comorbid depression in a population-based sample of women. J Womens Health (Larchmt). 2014;23(2):120–8.
Ferrante D, Linetzky B, Ponce M, Goldberg L, Konfino J, Laspiur S. Prevalencia de sobrepeso, obesidad, actividad física y tabaquismo en adolescentes argentinos: Encuestas Mundiales de Salud Escolar y de Tabaco en Jóvenes, 2007–2012. Arch argent pediatr. 2014;112(6):496–503.
Firoz T, Ateka-Barrutia O, Rojas-Suarez JA, Wijeyaratne C, Castillo E, Lombaard H, Magee LA. Global obstetric medicine: Collaborating towards global progress in maternal health. Obstetric Medicine. 2015;8(3):138–45.
Firoz T, McCaw-Binns A, Filippi V, Magee LA, Costa ML, Cecatti JG, Barreix M, Adanu R, Chou D, Say L, et al. A framework for healthcare interventions to address maternal morbidity. Int J Gynecol Obstet. 2018;141(Supplement 1):61–8.
Förger F, Østensen M, Schumacher A, Villiger PM. Impact of pregnancy on health related quality of life evaluated prospectively in pregnant women with rheumatic diseases by the SF-36 health survey. Ann Rheum Dis. 2005;64(10):1494–9.
Frayne DJ. Preconception care is primary care: A call to action. Am Fam Physician. 2017;96(8):492–4.
Ghodrati F, Saadatmand N, Gholamzadeh S, Akbarzadeh M. The seven-year epidemiological study of legal abortion caused by heart disease, blood disorders, diabetes and hypertension as referred to forensic medicine centers in Fars Province. Fam Med Prim Care Rev. 2019;21(1):23–9.
Gibson-Helm ME, Bailie J, Matthews V, Laycock AF, Boyle JA, Bailie RS. Identifying evidence-practice gaps and strategies for improvement in Aboriginal and Torres Strait Islander maternal health care. PLoS One. 2018;13(2):e0192262.
Goldfarb SS, Smith W, Epstein AE, Burrows S, Wingate M. Disparities in Prenatal Care Utilization Among U.S. Versus Foreign-Born Women with Chronic Conditions. J Immigr Minor Health. 2017;19(6):1263–70.
Gonzales G, Quinones N, Attanasio L. Health and Access to Care among Reproductive-Age Women by Sexual Orientation and Pregnancy Status. Womens Health Issues. 2019;29(1):8–16.
Griffiths E, Marley JV, Atkinson D. Preconception care in a remote aboriginal community context: What, when and by whom? Int J Environ Res Public Health. 2020;17(10):3702.
Griffiths F, Lowe P, Boardman F, Ayre C, Gadsby R. Becoming pregnant: exploring the perspectives of women living with diabetes. Br J Gen Pract. 2008;58(548):184–90.
Guern VL, Rossignol M, Proust A. Maternal mortality in France: 6th Report from the National Confidential Enquiry 2013–2015-Indirect causes of maternal deaths (except stroke, cardiovascular diseases and infections), France 2013–2015. Gynecologie, Obstetrique, Fertilite & Senologie. 2020;05:05.
Hadar E, Ashwal E, Hod M. The preconceptional period as an opportunity for prediction and prevention of noncommunicable disease. Best Pract Res Clin Obstet Gynaecol. 2015;29(1):54–62.
Hall KS, Steinberg JR, Cwiak CA, Allen RH, Marcus SM. Contraception and mental health: A commentary on the evidence and principles for practice. Am J Obstet Gynecol. 2015;212(6):740–6.
Hameen-Anttila K, Kokki E, Lupattelli A, Nordeng H, Jyrkka J, Vainio K, Enlund H. Factors associated with the need for information about medicines among pregnant women - A multinational internet-based survey. Res Social Adm Pharm. 2015;11(2):297–302.
Hanson M, Jacob CM, Hod M, Killeen SL, McAuliffe FM. The FIGO Pregnancy Obesity and Nutrition Initiative (PONI). Int J Gynecol Obstet. 2019;147(2):131–3.
Heyes T, Long S, Mathers N. Preconception care: Practice and beliefs of primary care workers. Fam Pract. 2004;21(1):22–7.
Hill B, Skouteris H, Boyle JA, Bailey C, Walker R, Thangaratinam S, Sundseth H, Stephenson J, Steegers E, Redman LM, et al. Health in preconception, pregnancy and postpartum global alliance: international network pregnancy priorities for the prevention of maternal obesity and related pregnancy and long-term complications. J Clin Med. 2020;9(3):822.
Hohmann-Marriott BE. Unplanned pregnancies of women with chronic health conditions in New Zealand. N Z Med J. 2019;132(1499):11–7.
Homish GG, Cornelius JR, Richardson GA, Day NL. Antenatal risk factors associated with postpartum comorbid alcohol use and depressive symptomatology. Alcohol Clin Exp Res. 2004;28(8):1242–8.
Hunter-Greaves T, Medley-Singh N, Tate N, McDaniel A, Simms-Stewart D, Rattray C. Contraceptive practices in women with chronic medical conditions. J Obstet Gynaecol. 2020;41(4):626–30.
Hussein J. Non-communicable diseases during pregnancy in low and middle income countries. Obstetric Medicine. 2017;10(1):26–9.
Jack B, Atrash HK. Special Issue: Preconception health and health care - the clinical content of preconception care. (Special Issue: Preconception health and health care - the clinical content of preconception care.). AJOG. 2008;199(62):S257–396.
Jacob CM, Killeen SL, McAuliffe FM, Stephenson J, Hod M, Diaz Yamal I, Malhotra J, Mocanu E, McIntyre HD, Kihara AB, et al. Prevention of noncommunicable diseases by interventions in the preconception period: A FIGO position paper for action by healthcare practitioners. Int J Gynecol Obstet. 2020;151(S1):6–15.
Johnson KA, Gee RE. Interpregnancy care. Semin Perinatol. 2015;39(4):310–5.
Kallas-Koeman M, Khandwala F, Donovan LE. Rate of preconception care in women with type 2 diabetes still lags behind that of women with type 1 diabetes. Can J Diabetes. 2012;36(4):170–4.
Kanguru L, McCaw-Binns A, Bell J, Yonger-Coleman N, Wilks R, Hussein J. The burden of obesity in women of reproductive age and in pregnancy in a middle-income setting: A population based study from Jamaica. PLoS One. 2017;12(12):e0188677.
Kapur A. The links between maternal and child health and noncommunicable diseases-the threat and opportunity for global health. TMIH. 2013;18:26.
Kapur A. Links between maternal health and NCDs. Best Pract Res Clin Obstet Gynaecol. 2015;29(1):32–42.
Katon JG, Russo J, Gavin AR, Melville JL, Katon WJ. Diabetes and depression in pregnancy: is there an association? J Womens Health (Larchmt). 2011;20(7):983–9.
Katon W, Russo J, Gavin A. Predictors of postpartum depression. J Womens Health. 2014;23(9):753–9.
Katon WJ, Russo JE, Melville JL, Katon JG, Gavin AR. Depression in pregnancy is associated with preexisting but not pregnancy-induced hypertension. Gen Hosp Psychiatry. 2012;34(1):9–16.
Kersten I, Lange AE, Haas JP, Fusch C, Lode H, Hoffmann W, Thyrian JR. Chronic diseases in pregnant women: prevalence and birth outcomes based on the SNiP-study. BMC Pregnancy Childbirth. 2014;14:75.
Kikuchi K, Ayer R, Okawa S, Nishikitani M, Yokota F, Jimba M, Nakashima N. Interventions integrating non-communicable disease prevention and reproductive, maternal, newborn, and child health: A systematic review. Biosci Trends. 2018;12(2):116–25.
Kim C, Ferrara A, McEwen LN, Marrero DG, Gerzoff RB, Herman WH. Preconception care in managed care: the translating research into action for diabetes study. Am J Obstet Gynecol. 2005;192(1):227–32.
King NMA, Chambers J, O’Donnell K, Jayaweera SR, Williamson C, Glover VA. Anxiety, depression and saliva cortisol in women with a medical disorder during pregnancy. Arch Womens Ment Health. 2010;13(4):339–45.
King R, Wellard S. Juggling type 1 diabetes and pregnancy in rural Australia. Midwifery. 2009;25(2):126–33.
Kizirian NV, Black K, Hespe C, Sim KA, Musgrave L, Gordon A. Understanding and provision of preconception care by general practitioners. J Paediatr Child Health. 2018;54(Supplement 1):28.
Knight M. The findings of the MBRRACE-UK confidential enquiry into Maternal Deaths and Morbidity. Obstet Gynaecol Reprod Med. 2019;29(1):21–3.
Kozhimannil KB, Pereira MA, Harlow BL. Association between diabetes and perinatal depression among low-income mothers. JAMA. 2009;301(8):842–7.
Ladusingh L, Mohanty SK, Thangjam M. Triple burden of disease and out of pocket healthcare expenditure of women in India. PLOS One. 2018;13(5):e0196835.
Lang AJ, Rodgers CS, Lebeck MM. Associations between maternal childhood maltreatment and psychopathology and aggression during pregnancy and postpartum. Child Abuse Negl. 2006;30(1):17–25.
Lange U, Schnepp W, ZuSayn-Wittgenstein F. The experiences of chronically ill women in the time of pregnancy, birth and postnatal period - a review of qualitative studies. [German]. Zeitschrift fur Geburtshilfe und Neonatologie. 2015;219(4):161–9.
Lassi ZS, Dean SV, Mallick D, Bhutta ZA. Preconception care: Delivery strategies and packages for care. Reproductive Health. 2014;11(3):S7.
Lavender T, Platt MJ, Tsekiri E, Casson I, Byrom S, Baker L, Walkinshaw S. Women’s perceptions of being pregnant and having pregestational diabetes. Midwifery. 2010;26(6):589–95.
Law A, McCoy M, Lynen R, Curkendall SM, Gatwood J, Juneau PL, Landsman-Blumberg P. The Additional Cost Burden of Preexisting Medical Conditions during Pregnancy and Childbirth. J Womens Health. 2015;24(11):924–32.
Le Guern V, Rossignol M, Proust A. Indirect causes of maternal deaths (except stroke, cardiovascular diseases and infections): Results from the French confidential enquiry into maternal deaths, 2010–2012. Gynecologie Obstetrique Fertilite et Senologie. 2017;45(12 Supplement):S71–80.
Lee JY, Ko YJ, Park SM. Factors associated with current smoking and heavy alcohol consumption among women of reproductive age: the Fourth Korean National Health and Nutrition Examination Survey 2007–2009. Public Health. 2013;127(5):473–81.
Leung WC, Kung F, Lam J, Leung TW, Ho PC. Domestic violence and postnatal depression in a Chinese community. Int J Gynaecol Obstet. 2002;79(2):159–66.
Lin SC, Tyus N, Maloney M, Ohri B, Sripipatana A. Mental health status among women of reproductive age from underserved communities in the United States and the associations between depression and physical health. A cross-sectional study. PLoS One. 2020;15(4):13.
Lipson JG, Rogers JG. Pregnancy, birth, and disability: women’s health care experiences. Health Care Women Int. 2000;21(1):11–26.
Lupattelli A, Spigset O, Nordeng H. Adherence to medication for chronic disorders during pregnancy: results from a multinational study. Int J Clin Pharm. 2014;36(1):145–53.
Mahadevan U, Matro R. Care of the Pregnant Patient With Inflammatory Bowel Disease. Obstet Gynecol. 2015;126(2):401–12.
Maina WK. Integrating noncommunicable disease prevention into maternal and child health programs: Can it be done and what will it take? Int J Gynecol Obstet. 2011;115:S34–6.
Malhame I, Pilote L, Destine R, Israel K, von Oettingen JE. Capacity Building and Innovation in Caring for Non-communicable Diseases in Maternal Global Health: The Example of Haiti. J Obstet Gynaecol Can. 2019;41(10):1479–81.
Malm H, Martikainen J, Klaukka T, Neuvonen PJ, Finnish Register-Based S. Prescription drugs during pregnancy and lactation–a Finnish register-based study. Eur J Clin Pharmacol. 2003;59(2):127–33.
Manaf RA, Ismail IZ, Latiff LA. Contraceptive use among women with chronic medical conditions and factors associated with its non-use in Malaysia. Global J Health Sci. 2012;4(5):91–9.
Margerison CE, MacCallum CL, Chen JJ, Zamani-Hank Y, Kaestner R. Impacts of Medicaid Expansion on Health Among Women of Reproductive Age. Am J Prev Med. 2020;58(1):1–11.
Matjila MJ, Hoffman A, van der Spuy ZM. Medical conditions associated with recurrent miscarriage-Is BMI the tip of the iceberg? Eur J Obstet Gynecol Reprod Biol. 2017;214:91–6.
Matone M, Minkovitz C, Quarshie W, Rubin DM. Ahrens: Chronic disease prevalence and discontinuation of medications among young mothers with a relationship to the child welfare system. Child Youth Serv Rev. 2016;64:66–72.
McCabe JE, Katon JG, Ma E, Fortney JC, Grote NK, Zephyrin LC, Callegari LS. Preconception Health Risk Factors in Women with and without a History of Military Service. Womens Health Issues. 2018;28(6):539–45.
McCaw-Binns A, Alexander SF, Lindo JLM, Escoffery C, Spence K, Lewis-Bell K, Lewis G. Epidemiologic transition in maternal mortality and morbidity: New challenges for Jamaica. Int J Gynecol Obstet. 2007;96(3):226–32.
McCaw-Binns AM, Campbell LV, Spence SS. The evolving contribution of non-communicable diseases to maternal mortality in Jamaica, 1998–2015: a population-based study. BJOG. 2018;125(10):1254–61.
McCorry NK, Hughes C, Spence D, Holmes VA, Harper R. Pregnancy planning and diabetes: a qualitative exploration of women’s attitudes toward preconception care. J Midwifery Womens Health. 2012;57(4):396–402.
Meade T, Sharpe L, Hallab L, Aspanell D, Manolios N. Navigating motherhood choices in the context of rheumatoid arthritis: women’s stories. Musculoskeletal Care. 2013;11(2):73–82.
Melville JL, Gavin A, Guo Y, Fan MY, Katon WJ. Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstet Gynecol. 2010;116(5):1064–70.
Menard MK, Goodnight WH. The role of specialists in providing preconception health care and guidance to women with chronic medical conditions. N C Med J. 2009;70(5):445–8.
Miller ES, Peri MR, Gossett DR. The association between diabetes and postpartum depression. Arch Womens Ment Health. 2016;19(1):183–6.
Milln JM, Nakimuli A. Medical complications in pregnancy at Mulago Hospital Uganda’s national referral hospital. Obstet Med. 2019;12(4):168–74.
Mittal P, Dandekar A, Hessler D. Use of a modified reproductive life plan to improve awareness of preconception health in women with chronic disease. Perm J. 2014;18(2):28–32.
Moon TD, Silva-Matos C, Cordoso A, Baptista AJ, Sidat M, Vermund SH. Implementation of cervical cancer screening using visual inspection with acetic acid in rural Mozambique: successes and challenges using HIV care and treatment programme investments in Zambézia Province. J Int AIDS Soc. 2012;15(2):17406.
Mpofu JJ, de Moura L, Farr SL, Malta DC, Iser BM, Bernal RTI, Robbins CL, Lobelo F. Associations between noncommunicable disease risk factors, race, education, and health insurance status among women of reproductive age in Brazil—2011. Prev Med Rep. 2016;3:333–7.
Murphy HR, Temple RC, Ball VE, Roland JM, Steel S, Zill EHR, Simmons D, Royce LR, Skinner TC. Personal experiences of women with diabetes who do not attend pre-pregnancy care. Diabet Med. 2010;27(1):92–100.
Murphy V, Whalen O, Karayanidis F, Lane A, Campbell L. The mental health characteristics of women with asthma in the antenatal and postnatal period. Respirology (carlton, vic). 2017;22:162–3.
Nascimento NC, Borges ALV, Fujimori E. Preconception health behaviors among women with planned pregnancies. Rev Bras Enferm. 2019;72(Supplement 3):17–24.
Navaro M, Vezzosi L, Santagati G, Angelillo IF, Collaborative Working G. Knowledge, attitudes, and practice regarding medication use in pregnant women in Southern Italy. PLoS One. 2018;13(6):e0198618.
Nelson-Piercy C, de Swiet M, Lewis G. Medical deaths in pregnancy. Clin Med. 2008;8(1):11–2.
Nelson-Piercy C, Vlaev I, Harris K, Fischer-Betz R. What factors could influence physicians’ management of women of childbearing age with chronic inflammatory disease? A systematic review of behavioural determinants of clinical inertia. BMC Health Serv Res. 2019;19(1):863.
Ojukwu O, Patel D, Stephenson J, Howden B, Shawe J. General practitioners’ knowledge, attitudes and views of providing preconception care: a qualitative investigation. Upsala J Med Sci. 2016;121(4):256–63.
Pajulo M, Savonlahti E, Sourander A, Ahlqvist S, Helenius H, Piha J. An early report on the mother-baby interactive capacity of substance-abusing mothers. J Subst Abuse Treat. 2001;20(2):143–51.
Payne D, McPherson KM. Becoming mothers. Multiple sclerosis and motherhood: a qualitative study. Disabil Rehabil. 2010;32(8):629–38.
Penn-Newman D, Shaw S, Congalton D, Strommer S, Morris T, Lawrence W, Chase D, Cooper C, Barker M, Baird J. How well do national and local policies in England relevant to maternal and child health meet the international standard for non-communicable disease prevention? A policy analysis. BMJ Open. 2018;8(11):e022062.
Pivarnik JM, Chambliss HO, Clapp JF, Dugan SA, Hatch MC, Lovelady CA, Mottola MF, Williams MA. Impact of physical activity during pregnancy and postpartum on chronic disease risk. Med Sci Sports Exerc. 2006;38(5):989–1006.
Plotkin M, Besana GV, Yuma S, Kim YM, Kulindwa Y, Kabole F, Lu E, Giattas MR. Integrating HIV testing into cervical cancer screening in Tanzania: an analysis of routine service delivery statistics. BMC Womens Health. 2014;14:120.
Raatikainen K, Heiskanen N, Heinonen S. Induced Abortion: Not an Independent Risk Factor for Pregnancy Outcome, But a Challenge for Health Counseling. Ann Epidemiol. 2006;16(8):587–92.
Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002–2010 in Finland. BMJ Open. 2014;4(11):e004883.
Raymond SU, Greenberg HM, Leeder SR. Beyond reproduction: women’s health in today’s developing world. Int J Epidemiol. 2005;34(5):1144–8.
Razaz N, Tremlett H, Marrie RA, Joseph KS. Peripartum depression in parents with multiple sclerosis and psychiatric disorders in children. Mult Scler. 2016;22(14):1830–40.
Records K, Rice MJ. A comparative study of postpartum depression in abused and non-abused women. Arch Psychiatr Nurs. 2005;19(6):281–90.
Reiter SF, Veiby G, Daltveit AK, Engelsen BA, Gilhus NE. Psychiatric comorbidity and social aspects in pregnant women with epilepsy - the Norwegian Mother and Child Cohort Study. Epilepsy Behav. 2013;29(2):379–85.
Requejo JH, Bustreo F. Putting maternal health in perspective with a life course approach to women’s health. J Womens Health. 2016;25(3):211–2.
Riley EH, Fuentes-Afflick E, Jackson RA, Escobar GJ, Brawarsky P, Schreiber M, Haas JS. Correlates of prescription drug use during pregnancy. J Womens Health. 2005;14(5):401–9.
Robbins C, Boulet SL, Morgan I, D’Angelo DV, Zapata LB, Morrow B, Sharma A, Kroelinger CD. Disparities in Preconception Health Indicators - Behavioral Risk Factor Surveillance System, 2013–2015, and Pregnancy Risk Assessment Monitoring System, 2013–2014. Morb Mortal Wkly Rep Recomm Rep. 2018;67(1):1–16.
Ross LE, Dennis CL. The prevalence of postpartum depression among women with substance use, an abuse history, or chronic illness: A systematic review. J Womens Health. 2009;18(4):475–86.
Rosser ML, McAndrew TC, Brusati AJ. Obstetricians/gynecologists and heart health: Untapped allies in the fight on cardiovascular disease. J Am Coll Cardiol. 2013;61:E1458.
Sablock U, Lindow SW, Arnott PI, Masson EA. Prepregnancy counselling for women with medical disorders. J Obstet Gynaecol. 2002;22(6):637–8.
Sapiano K, Savona-Ventura C, Calleja-Agius J, Serracino-Inglott A, Azzopardi LM. Attitudes towards preconception care in Maltese women with type 1 diabetes mellitus. Gynecol Endocrinol. 2012;28(12):1006–9.
Sarid O, Segal-Engelchin D, Cwikel J. The contribution of negative reproductive experiences and chronic medical conditions to depression and pain among Israeli women. Psychol Health Med. 2012;17(1):82–94.
Segev Y, Riskin-Mashiah S, Lavie O, Auslender R. Assisted reproductive technologies: Medical safety issues in the older woman. J Womens Health. 2011;20(6):853–61.
Sikder SS, Labrique AB, Ullah B, Mehra S, Rashid M, Ali H, Jahan N, Shamim AA, West KP, Christian P. Care-seeking patterns for fatal non-communicable diseases among women of reproductive age in rural northwest Bangladesh. BMC Womens Health. 2012;12:7.
Silverman ME, Reichenberg A, Savitz DA, Cnattingius S, Lichtenstein P, Hultman CM, Larsson H, Sandin S. The risk factors for postpartum depression: A population-based study. Depress Anxiety. 2017;34(2):178–87.
Sina BJ. Pregnancy and the global disease burden. Reprod Health. 2017;14(Supplement 3):170.
Song D, Sands RG. Wong Y-LI, Arnold: Utilization of Mental Health Services by Low-Income Pregnant and Postpartum Women on Medical Assistance. Women Health. 2004;39(1):1–24.
Steegers-Theunissen RPM. Periconception mHealth platform for prevention of placental-related outcomes and non-communicable diseases. Placenta. 2017;60:115–8.
Steel A, Lucke J, Adams J. The prevalence and nature of the use of preconception services by women with chronic health conditions: An integrative review. BMC Women’s Health. 2015;15(1):14.
Stevens J, Ammerman RT, Putnam FG, Van Ginkel JB. Depression and trauma history in first-time mothers receiving home visitation. J Community Psychol. 2002;30(5):551–64.
Tebbet M, Kennedy P. The experience of childbirth for women with spinal cord injuries: an interpretative phenomenology analysis study. Disabil Rehabil. 2012;34(9):762–9.
Temmerman M, Khosla R, Laski L, Mathews Z, Say L. Women’s health priorities and interventions. BMJ (Online). 2015;351:4–9.
Thandar MM, Kiriya J, Shibanuma A, Ong KIC, Tin KN, Win HH, Jimba M. Women’s knowledge on common non-communicable diseases and nutritional need during pregnancy in three townships of Ayeyarwaddy region, Myanmar: A cross-sectional study. Trop Med Health. 2019;47(1):12.
Thomas H. Pregnancy, illness and the concept of career. Sociol Health Illn. 2003;25(5):383–407.
Thomas H. Women’s postnatal experience following a medically complicated pregnancy. Health Care Women Int. 2004;25(1):76–87.
Thompson D, Thomas H, Solomon J, Nashef L, Kendall S. Chronic illness, reproductive health and moral work: women’s experiences of epilepsy. Chronic Illn. 2008;4(1):54–64.
Tripathi A, Rankin J, Aarvold J, Chandler C, Bell R. Preconception counseling in women with diabetes: a population-based study in the north of England. Diabetes Care. 2010;33(3):586–8.
Tyer-Viola LA, Lopez RP. Pregnancy with Chronic Illness. JOGNN. 2014;43(1):25–37.
Wilson-Mitchell K. Increasing Access to Prenatal Care: Disease Prevention and Sound Business Practice. Health Care Women Int. 2014;35(2):120–6.
World Health Organization. Preconception care: Regional Expert Group Consultation. https://apps.who.int/iris/bitstream/handle/10665/205637/B5124.pdf?sequence=1&isAllowed=y. Accessed 27 Nov 2020.
Yaya S, Reddy KS, Belizan JM, Pingray V. Non-communicable diseases and reproductive health in sub-Saharan Africa: Bridging the policy-implementation gaps. Reprod Health. 2020;17(1):8.
Zhu H, Graham D, Teh RW, Hornbuckle J. Utilisation of preconception care in women with pregestational diabetes in Western Australia. Aust N Z J Obstet Gynaecol. 2012;52(6):593–6.
Wilson Center. To Reduce US Maternal Mortality, Take Aim at Non-Communicable Diseases. https://www.wilsoncenter.org/publication/unseen-side-pregnancy-non-communicable-diseases-and-maternal-health. Accessed 27 Nov 2020.
Maternal Health Task Force. Tackling Noncommunicable Diseases and Maternal Mortality: A Conversation With Katja Iversen. https://www.mhtf.org/2017/12/15/tackling-noncommunicable-diseases-and-maternal-mortality-a-conversation-with-katja-iversen/. Accessed 27 Nov 2020.
Wilson Center. On the Beat: Non-Communicable Diseases and Maternal Health. https://www.newsecuritybeat.org/2017/12/beat-non-communicable-diseases-maternal-health/. Accessed 27 Nov 2020.
Wilson Center. The Unseen Side of Pregnancy: Non-Communicable Diseases and Maternal Health. https://www.wilsoncenter.org/publication/unseen-side-pregnancy-non-communicable-diseases-and-maternal-health. Accessed 27 Nov 2020.
University of Cape Town. Pregnancy, obesity and HIV explored in new study. http://www.publichealth.uct.ac.za/news/pregnancy-obesity-and-hiv-explored-new-study. Accessed 27 Nov 2020.
Maternal Health Task Force. Noncommunicable Diseases and Maternal Health. https://www.mhtf.org/topics/noncommunicable-diseases-and-maternal-health/. Accessed 27 Nov 2020.
Maternal Health Task Force. Experts Discuss Non-Communicable Diseases and Maternal Health. https://www.mhtf.org/2017/11/09/experts-discuss-non-communicable-diseases-and-maternal-health/. Accessed 27 Nov 2020.
Women Deliver. Addressing Noncommunicable Diseases to Deliver for Good. https://womendeliver.org/addressing-noncommunicable-diseases-to-deliver-for-good/. Accessed 27 Nov 2020.
Maternal Health Task Force. Beyond Reproductive and Maternal Health: Non-Communicable Diseases and Women’s Health. https://www.mhtf.org/2017/04/20/beyond-reproductive-and-maternal-health-non-communicable-diseases-and-womens-health/. Accessed 27 Nov 2020.
Maternal Health Task Force. To Address Noncommunicable Diseases and Maternal Health in Low-Resource Settings, Integrate Data at the Primary Care Level. https://www.mhtf.org/2018/03/15/to-address-noncommunicable-diseases-and-maternal-health-in-low-resource-settings-integrate-data-at-the-primary-care-level/. Accessed 27 Nov 2020.
Wilson Center. CODE BLUE: The Importance of Integrating Care for Maternal Health and Non-Communicable Disease. https://www.newsecuritybeat.org/2019/12/code-blue-importance-integrating-care-maternal-health-non-communicable-disease/. Accessed 27 Nov 2020.
Women Deliver. Women and NCDs in Humanitarian Emergencies. https://womendeliver.org/women-ncds-humanitarian-emergencies/#:~:text=Women%20tend%20to%20be%20affected,those%20suffering%20from%20chronic%20diseases. Accessed 27 Nov 2020.
Ending Eclampsia. Maternal Health Efforts Can Prevent Non-communicable Diseases. http://www.endingeclampsia.org/maternal-health-efforts-can-prevent-non-communicable-diseases/. Accessed 27 Nov 2020.
Maternal Health Task Force. Insight Into Non-Communicable Diseases and Maternal Health Around the Globe. https://www.mhtf.org/2018/03/27/insight-into-non-communicable-diseases-and-maternal-health-around-the-globe/#:~:text=Insight%20Into%20Non%2DCommunicable%20Diseases%20and%20Maternal%20Health%20Around%20the%20Globe,-Posted%20on%20March&text=In%20many%20parts%20of%20the,%2Dcommunicable%20diseases%20(NCDs). Accessed 27 Nov 2020.
The Star. The danger of non-communicable diseases in pregnancy. https://www.thestar.com.my/lifestyle/family/2019/04/19/danger-non-communicable-diseases-pregnancy. Accessed 27 Nov 2020.
Global Burden of Disease Study 2017 (GBD 2017) Results. Institute for Health Metrics and Evaluation (IHME). http://ghdx.healthdata.org/gbd-results-tool. Accessed 27 Nov 2020.
Firoz T, Chou D, von Dadelszen P, Agrawal P, Vanderkruik R, Tunçalp O, Magee LA, van Den Broek N, Say L. Maternal Morbidity Working Group. Measuring maternal health: focus on maternal morbidity. Bull World Health Organ. 2013;91(10):794–6.
Barreix M, Barbour K, McCaw-Binns A, Chou D, Petzold M, Gichuhi GN, Gadama L, Taulo F, Tunçalp Ö, Say L. WHO Maternal Morbidity Working Group (MMWG) Standardizing the measurement of maternal morbidity: Pilot study results. Int J Gynaecol Obstet. 2018;141 Suppl 1(Suppl Supple 1):10–9.
Chersich M, Blaauw D, Dumbaugh M, Penn-Kekana L, Thwala S, Bijlmakers L, Vargas E, Kern E, Kavanagh J, Dhana A, Becerra-Posada F, Mlotshwa L, Becerril-Montekio V, Mannava P, Luchters S, Pham MD, Portela AG, Rees H. Mapping of research on maternal health interventions in low- and middle-income countries: a review of 2292 publications between 2000 and 2012. Global Health. 2016;12(1):52.
Mounier-Jack S, Mayhew SH, Mays N. Integrated care: learning between high-income, and low- and middle-income country health systems. Health Policy Plan. 2017;32(suppl_4):iv6–12.
World Health Organization. Strategies toward Ending Preventable Maternal Mortality. http://who.int/reproductivehealth/topics/maternal_perinatal/epmm/en/. Accessed 3 Jan 2022.
The authors would like to thank Simroop Ladhar for her assistance with data organization.
HRP (the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.
Ethics approval and consent to participate
Consent for publication
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Additional file 1:
Table S1. Reporting guideline checklist. Table S2. Search Strategies. Table S3. Conditions by organ system.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Firoz, T., Pineles, B., Navrange, N. et al. Non-communicable diseases and maternal health: a scoping review. BMC Pregnancy Childbirth 22, 787 (2022). https://doi.org/10.1186/s12884-022-05047-6
- Non-communicable diseases
- Maternal health