{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:50:02Z","timestamp":1785178202723,"version":"3.55.0"},"reference-count":57,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Preexisting and pregnancy\u2010related medical conditions frequently co\u2010occur, leading to multimorbidity (\u22652 morbidities) in pregnant women, and much of this information is in semi\u2010structured format in electronic medical records (EMRs). The aim was to advance the learning health system as a platform for automating information extraction from EMRs and to uncover the prevalence of common morbidities during pregnancy and their association with pregnancy\u2010related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 48\u2009502 pregnant women attending Monash Health maternity hospitals from 2016 to 2021. Natural language processing (NLP) was used to extract morbidities from semi\u2010structured text in EMRs. Chi\u2010squared tests were used to assess the association between morbidities of gestational diabetes mellitus (GDM) and other pregnancy complications. The <jats:italic>k<\/jats:italic>\u2010means clustering algorithm identified clusters of comorbid conditions associated with GDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most common comorbidities during pregnancy were vitamin deficiency (14\u2009019; 28.9%), overweight (13\u2009918; 28.7%), obesity (11\u2009026; 22.7%), anemia and other blood\u2010related disorders (4821; 9.9%), mental health disorders (4314; 9.8%), asthma (4126; 8.5%), thyroid diseases (3576; 7.4%), endometrial disease (1927; 3.9%), cardiovascular disease (1525; 3.1%), and polycystic ovary syndrome (PCOS) (1464; 3.0%). While 22.5% of women had no medical conditions, 77.5% had one or more. Multimorbidity was associated with conditions including overweight, obesity, vitamin deficiency, thyroid disease, substance use, PCOS, GDM, and endometrial diseases. On cluster analysis, aged 35\u2009years or older, overweight, vitamin deficiency, obesity, thyroid disease, asthma, uterine disease, other blood disorders, mental disorders, and PCOS were associated with GDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>More than three\u2010quarters of pregnant women in the Australian urban setting experienced one or more morbidities during pregnancy, which can be associated with adverse pregnancy outcomes. This project contributes to developing a learning health system infrastructure to deliver high\u2010value maternal health care while reducing costs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lrh2.10473","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T11:34:59Z","timestamp":1732620899000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Analyzing electronic medical records to extract prepregnancy morbidities and pregnancy complications: Toward a learning health system"],"prefix":"10.1002","volume":"9","author":[{"given":"Yitayeh","family":"Belsti","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Moran","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Mousa","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"},{"name":"Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Lorber","family":"Rolnik","sequence":"additional","affiliation":[{"name":"Monash Health  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology, School of Clinical Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahnaz Bahri","family":"Khomami","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihiretu M.","family":"Kebede","sequence":"additional","affiliation":[{"name":"German Cancer Research Center (DKFZ)  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Teede","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"},{"name":"Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Enticott","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3012"},{"key":"e_1_2_11_3_1","volume-title":"Tintinalli's Emergency Medicine: A Comprehensive Study Guide","author":"Whelan LJ","year":"2016"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2019.1691243"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1855_21"},{"key":"e_1_2_11_6_1","unstructured":"Australian Institute of Health and Welfare.Australia's mothers and babies maternal age.2023Accessed at January 10 2024. 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