{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:50:06Z","timestamp":1785178206484,"version":"3.55.0"},"reference-count":27,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Ministry of the Environment, Japan","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,7,22]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the association between multimorbidity during pregnancy and neurodevelopmental delay in offspring using data from a Japanese nationwide birth cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This study was a prospective birth cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This study population included 104\u2009059 fetal records who participated in The Japan Environment and Children\u2019s Study from 2011 to 2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Pregnant women whose children had undergone developmental testing were included in this analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Neurodevelopment of offspring was assessed using the Japanese version of the Ages and Stages Questionnaire, third edition, comprising five developmental domains. The number of comorbidities among the pregnant women was categorised as zero, single disease or multimorbidity (two or more diseases). Maternal chronic conditions included in multimorbidity were defined as conditions with high prevalence among women of reproductive age. A multivariate logistic regression analysis was conducted to examine the association between multimorbidity in pregnant women and offspring development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pregnant women with multimorbidity, single disease and no disease accounted for 3.6%, 30.6% and 65.8%, respectively. The ORs for neurodevelopmental impairment during the follow-up period were similar for infants of mothers with no disease comorbidity and those with a single disease comorbidity. However, the ORs for neurodevelopmental impairment were significantly higher for children born to mothers with multimorbidity compared with those born to healthy mothers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An association was observed between the number of comorbidities in pregnant women and developmental delay in offspring. Multimorbidity in pregnant women may be associated with neurodevelopmental delay in their offspring. Further research is required in this regard in many other regions of the world.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-082585","type":"journal-article","created":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T13:02:51Z","timestamp":1722690171000},"page":"e082585","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Association between maternal multimorbidity and neurodevelopment of offspring: a prospective birth cohort study from the Japan Environment and Children\u2019s Study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2508-0704","authenticated-orcid":false,"given":"Takanobu","family":"Akagi","sequence":"first","affiliation":[{"name":"Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6211-8202","authenticated-orcid":false,"given":"Yasuaki","family":"Saijo","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3316-1057","authenticated-orcid":false,"given":"Eiji","family":"Yoshioka","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0409-584X","authenticated-orcid":false,"given":"Kentaro","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhito","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Nagaya","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiya","family":"Ito","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyoshi","family":"Iwata","sequence":"additional","affiliation":[{"name":"Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6329-0437","authenticated-orcid":false,"given":"Takeshi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chihiro","family":"Miyashita","sequence":"additional","affiliation":[{"name":"Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Ito","sequence":"additional","affiliation":[{"name":"Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8173-9269","authenticated-orcid":false,"given":"Reiko","family":"Kishi","sequence":"additional","affiliation":[{"name":"Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,3]]},"reference":[{"key":"2025121602580906000_14.8.e082585.1","unstructured":"World Health Organization . 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