UK study aims to transform maternity care for high-risk pregnancies

A new UK study aims to improve maternity care for pregnant women living with multiple long-term health conditions.

The three-year project, led by the University of Aberdeen and Birmingham City University, brings together experts from academia and the NHS, including King’s College London, the University of Birmingham, Manchester University, Barts Health NHS Trust, Newcastle-upon-Tyne NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust.

The research is supported by a £1.3m award from the National Institute for Health and Care Research (NIHR), with £70,000 of the funding going to King’s College London.

Recent figures show that more than 80 women die each year in the UK due to complications arising from pregnancy, while more than one in six pregnant women are living with multiple long-term conditions such as diabetes, high blood pressure, heart disease and mental health disorders.

These conditions are becoming increasingly common and are considered an important contributor to poor maternal outcomes.

There are currently no defined care requirements for pregnant women living with more than one long-term health condition.

Women living with multiple conditions can face changes to medication, disjointed care from multiple teams, conflicting advice between healthcare professionals and a lack of appropriate follow-up for their health conditions after birth.

Pregnant women with multiple long-term health conditions are at twice the risk of preterm birth and nine times more likely to die during pregnancy than those without these health complications.

Researchers will develop a “care bundle”, a package of evidence-led care designed to guide safe maternity care for women living with multiple long-term health conditions throughout pregnancy, birth and the postnatal period.

At King’s, Professor Krishnarajah Nirantharakumar and Professor Jane Sandall will be co-investigators on the project, contributing expertise in implementation research and continuity of maternity models of care. Zoe Vowles, an NIHR-funded midwife PhD student, will contribute expertise from her research into the contribution of midwifery to care for women with multiple long-term health conditions.

Sandall, professor of social science and women’s health at King’s College London, said: “Too many women living with more than one long-term health condition are falling through the gaps between different parts of the health system during pregnancy, when they most need coordinated support. This research will bring together expertise from across maternity and specialist care to build a care bundle that gives women and health professionals clear, consistent guidance, before, during and after birth.”

Nirantharakumar, clinical professor of public health and health data science at King’s College London, said: “Our MRC-funded MuM-PreDiCT programme worked directly with women living with multiple long-term conditions and with maternity clinicians to identify the elements of care that matter most in pregnancy. This award takes those elements and builds them into a care bundle that can be tested and delivered in the NHS.”

Over three years, the team will be led by Dr Mairead Black, clinical reader in obstetrics at the University of Aberdeen and honorary consultant obstetrician at NHS Grampian. It will address the challenges these women face and create a package of care aimed at reducing the risks they encounter in pregnancy.

The care bundle will include guidance on medication management, communication between healthcare teams, midwifery care and postnatal handovers. Researchers will also work with people with lived experience of maternity care to help shape and test it.

The researchers hope the project will provide an evidence-led care bundle specifically designed for women living with multiple long-term health conditions and, for the first time, clear guidance to support their complex needs throughout pregnancy and beyond.