{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:43:45Z","timestamp":1779191025166,"version":"3.51.4"},"reference-count":52,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"unspecified","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/W014432\/1"],"award-info":[{"award-number":["MR\/W014432\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Strategic Priority Fund","award":["MR\/W014432\/1"],"award-info":[{"award-number":["MR\/W014432\/1"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,12,12]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>With good medical care, most pregnancy complications like pre-eclampsia, gestational diabetes, etc resolve after childbirth. However, pregnancy complications are known to be associated with an increased risk of new long-term health conditions for women later in life, such as cardiovascular disease. These umbrella reviews aim to summarise systematic reviews evaluating the association between pregnancy complications and five groups of long-term health conditions: autoimmune conditions, cancers, functional disorders, mental health conditions and metabolic health conditions (diabetes and hypertension).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will conduct searches in Medline, Embase and the Cochrane database of systematic reviews without any language restrictions. We will include systematic reviews with or without meta-analyses that studied the association between pregnancy complications and the future risk of the five groups of long-term health conditions in women. Pregnancy complications were identified from existing core outcome sets for pregnancy and after consultation with experts. Two reviewers will independently screen the articles. Data will be synthesised with both narrative and quantitative methods. Where a meta-analysis has been carried out, we will report the combined effect size from individual studies. For binary data, pooled ORs with 95% CIs will be presented. For continuous data, we will use the mean difference with 95% CIs. The findings will be presented in forest plots to assess heterogeneity. The methodological quality of the studies will be evaluated with the AMSTAR 2 tool or the Cochrane risk of bias tool. The corrected covered area method will be used to assess the impact of overlap in reviews. The findings will be used to inform the design of prediction models, which will predict the risk of women developing these five group of health conditions following a pregnancy complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>No ethical approvals required. Findings will be disseminated through publications in peer-reviewed journals and conference presentations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-066476","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T13:04:03Z","timestamp":1672319043000},"page":"e066476","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Association of pregnancy complications\/risk factors with the development of future long-term health conditions in women: overarching protocol for umbrella reviews"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3680-7124","authenticated-orcid":false,"given":"Megha","family":"Singh","sequence":"first","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4026-1726","authenticated-orcid":false,"given":"Francesca","family":"Crowe","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shakila","family":"Thangaratinam","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK"},{"name":"Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn Mary","family":"Abel","sequence":"additional","affiliation":[{"name":"Medical and Human Sciences, Institute of Brain Behaviour and Mental Health, Manchester, UK"},{"name":"Centre for Women's Mental Health, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mairead","family":"Black","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Women\u2019s Health Research, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2745-4083","authenticated-orcid":false,"given":"Kelvin","family":"Okoth","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8699-0735","authenticated-orcid":false,"given":"Richard","family":"Riley","sequence":"additional","affiliation":[{"name":"Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly-Ann","family":"Eastwood","sequence":"additional","affiliation":[{"name":"St Michael\u2019s Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK"},{"name":"Centre for Public Health, Queen\u2019s University of Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly","family":"Hope","sequence":"additional","affiliation":[{"name":"Centre for Women's Mental Health, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Wambua","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jemma","family":"Healey","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Women\u2019s Health Research, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2332-5452","authenticated-orcid":false,"given":"Siang Ing","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0674-605X","authenticated-orcid":false,"given":"Katherine","family":"Phillips","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Vowles","sequence":"additional","affiliation":[{"name":"Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Cockburn","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngawai","family":"Moss","sequence":"additional","affiliation":[{"name":"Patient and public representative, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6816-1279","authenticated-orcid":false,"given":"Krishnarajah","family":"Nirantharakumar","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"2025121223351928000_12.12.e066476.1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/133.5.1592S"},{"key":"2025121223351928000_12.12.e066476.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2010.03205.x"},{"key":"2025121223351928000_12.12.e066476.3","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14236"},{"key":"2025121223351928000_12.12.e066476.4","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2020.100657","article-title":"Concerning trends in maternal risk factors in the United States: 1989-2018","volume":"29-30","author":"Bornstein","year":"2020","journal-title":"EClinicalMedicine"},{"key":"2025121223351928000_12.12.e066476.5","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03809-2"},{"key":"2025121223351928000_12.12.e066476.6","doi-asserted-by":"publisher","DOI":"10.1080\/14767050701209560"},{"key":"2025121223351928000_12.12.e066476.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2014.07.043"},{"key":"2025121223351928000_12.12.e066476.8","doi-asserted-by":"crossref","DOI":"10.1016\/j.envres.2020.109471","article-title":"Association between ambient air pollution and pregnancy complications: a systematic review and meta-analysis of cohort studies","volume":"185","author":"Bai","year":"2020","journal-title":"Environ Res"},{"key":"2025121223351928000_12.12.e066476.9","doi-asserted-by":"crossref","DOI":"10.3390\/ijms22158197","article-title":"Waterlogging-stress-responsive LncRNAs, their regulatory relationships with miRNAs and target genes in cucumber (Cucumis sativus L.)","volume":"22","author":"K\u0119ska","year":"2021","journal-title":"Int J Mol Sci"},{"key":"2025121223351928000_12.12.e066476.10","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/jhn.12999","article-title":"Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: a narrative review","volume":"35","author":"Langley-Evans","year":"2022","journal-title":"J Hum Nutr Diet"},{"key":"2025121223351928000_12.12.e066476.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03050.x"},{"key":"2025121223351928000_12.12.e066476.12","doi-asserted-by":"publisher","DOI":"10.1902\/annals.2003.8.1.70"},{"key":"2025121223351928000_12.12.e066476.13","unstructured":"World health organisation . Maternal mortality, 2022. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/maternal-mortality [Accessed Feb 2022]."},{"key":"2025121223351928000_12.12.e066476.14","doi-asserted-by":"crossref","unstructured":"Lale Say M , Chou D , Gemmill A . Global causes of maternal death: a who systematic analysis. 2, 2014: E323\u201333.","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"2025121223351928000_12.12.e066476.15","unstructured":"World health organisation . Maternal deaths fact sheet. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/maternal-mortality, [Accessed 22 Feb 2022]."},{"key":"2025121223351928000_12.12.e066476.16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7356.157"},{"key":"2025121223351928000_12.12.e066476.17","doi-asserted-by":"crossref","first-page":"76","DOI":"10.3390\/jcm6080076","article-title":"Long-term effects of pregnancy complications on maternal health: a review","volume":"6","author":"Neiger","year":"2017","journal-title":"J Clin Med"},{"key":"2025121223351928000_12.12.e066476.18","doi-asserted-by":"crossref","DOI":"10.3390\/medicina57121320","article-title":"Pregnancy complications can foreshadow future disease-long-term outcomes of a complicated pregnancy","volume":"57","author":"Panaitescu","year":"2021","journal-title":"Medicina"},{"key":"2025121223351928000_12.12.e066476.19","doi-asserted-by":"publisher","DOI":"10.1097\/00001703-200312000-00002"},{"key":"2025121223351928000_12.12.e066476.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.385301.BE"},{"key":"2025121223351928000_12.12.e066476.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.09.020"},{"key":"2025121223351928000_12.12.e066476.22","first-page":"101","article-title":"Reproductive health as a sentinel of chronic disease in women","volume":"5","author":"Rich-Edwards","year":"2009","journal-title":"Womens Health"},{"key":"2025121223351928000_12.12.e066476.23","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-016-4098-x"},{"key":"2025121223351928000_12.12.e066476.24","unstructured":"Knight MBK , Tuffnell D , Shakespeare J , on behalf of MBRRACE-UK . Saving Lives, Improving Mothers\u2019 Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2015-17. Oxford: National Perinatal Epidemiology Unit, University of Oxford, 2019."},{"key":"2025121223351928000_12.12.e066476.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.0730-7659.2004.00292.x"},{"key":"2025121223351928000_12.12.e066476.26","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/NMC.0000000000000311","article-title":"Implications of preterm birth for maternal mental health and infant development","volume":"42","author":"Anderson","year":"2017","journal-title":"MCN Am J Matern Child Nurs"},{"key":"2025121223351928000_12.12.e066476.27","doi-asserted-by":"publisher","DOI":"10.1136\/jech.50.5.481"},{"key":"2025121223351928000_12.12.e066476.28","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018443507512"},{"key":"2025121223351928000_12.12.e066476.29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/2070926","article-title":"Gestational diabetes mellitus and future cardiovascular risk: an update","volume":"2016","author":"Burlina","year":"2016","journal-title":"Int J Endocrinol"},{"key":"2025121223351928000_12.12.e066476.30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002488"},{"key":"2025121223351928000_12.12.e066476.31","doi-asserted-by":"crossref","unstructured":"Brennan P , Bankhead C , Silman A . Oral contraceptives and rheumatoid arthritis: results from a primary care-based incident case-control study. In: Seminars in arthritis and rheumatism. 26. Elsevier, 1997: 817\u201323.doi:10.1016\/S0049-0172(97)80025-X","DOI":"10.1016\/S0049-0172(97)80025-X"},{"key":"2025121223351928000_12.12.e066476.32","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.099945"},{"key":"2025121223351928000_12.12.e066476.33","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3502"},{"key":"2025121223351928000_12.12.e066476.34","unstructured":"Institute TJB . Joanna Briggs Institute Reviewers\u2019 Manual: 2014 edition \/ Supplement; 2014."},{"key":"2025121223351928000_12.12.e066476.35","unstructured":"PRISMA transparent reporting of systematic reviews and meta-analysis, 2022. Available: https:\/\/www.prisma-statement.org\/Extensions\/Protocols,assessed [Accessed Nov 2022]."},{"key":"2025121223351928000_12.12.e066476.36","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2018-300014"},{"key":"2025121223351928000_12.12.e066476.37","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/nae2.12039","article-title":"A nine\u2010step pathway to conduct an umbrella review of literature","volume":"32","author":"Cant","year":"2022","journal-title":"Nurse Author Ed"},{"key":"2025121223351928000_12.12.e066476.38","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"2025121223351928000_12.12.e066476.39","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-11-1"},{"key":"2025121223351928000_12.12.e066476.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2016.12.020"},{"key":"2025121223351928000_12.12.e066476.41","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1002\/jrsm.1508","article-title":"Including non-english language articles in systematic reviews: a reflection on processes for identifying low-cost sources of translation support","volume":"13","author":"Rockliffe","year":"2022","journal-title":"Res Synth Methods"},{"key":"2025121223351928000_12.12.e066476.42","unstructured":"Zoccai GB . Umbrella reviews: evidence synthesis with Overviews of reviews and Meta-Epidemiologic studies, 2016: 6.6."},{"key":"2025121223351928000_12.12.e066476.43","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008"},{"key":"2025121223351928000_12.12.e066476.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.10.002"},{"key":"2025121223351928000_12.12.e066476.45","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3507"},{"key":"2025121223351928000_12.12.e066476.46","doi-asserted-by":"crossref","unstructured":"Moher D , Tsertsvadze A , Tricco A , et al . When and how to update systematic reviews. Cochrane Database Syst Rev 2008;2010.doi:10.1002\/14651858.MR000023.pub3","DOI":"10.1002\/14651858.MR000023.pub3"},{"key":"2025121223351928000_12.12.e066476.47","doi-asserted-by":"crossref","first-page":"1095.e1","DOI":"10.1016\/j.jclinepi.2007.03.008","article-title":"A systematic review identified few methods and strategies describing when and how to update systematic reviews","volume":"60","author":"Moher","year":"2007","journal-title":"J Clin Epidemiol"},{"key":"2025121223351928000_12.12.e066476.48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.10.003"},{"key":"2025121223351928000_12.12.e066476.49","doi-asserted-by":"crossref","DOI":"10.1186\/s12874-021-01269-y","article-title":"Managing overlap of primary study results across systematic reviews: practical considerations for authors of overviews of reviews","volume":"21","author":"Lunny","year":"2021","journal-title":"BMC Med Res Methodol"},{"key":"2025121223351928000_12.12.e066476.50","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1002\/jrsm.1390","article-title":"Examining overlap of included studies in meta-reviews: guidance for using the corrected covered area index","volume":"11","author":"Hennessy","year":"2020","journal-title":"Res Synth Methods"},{"key":"2025121223351928000_12.12.e066476.51","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"2025121223351928000_12.12.e066476.52","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jclinepi.2020.09.018","article-title":"GRADE guidelines 30: the GRADE approach to assessing the certainty of modeled evidence-An overview in the context of health decision-making","volume":"129","author":"Brozek","year":"2021","journal-title":"J Clin Epidemiol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-066476","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:35:30Z","timestamp":1765611330000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-066476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":52,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,29]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/bmjopen-2022-066476"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-066476","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]}}}