{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:19:30Z","timestamp":1764890370486,"version":"3.46.0"},"reference-count":39,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,11]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Objectives<\/jats:title>\n To examine trends in preconception and pregnancy cardiometabolic risk factors and conditions, pregnancy and birth complications, obstetric interventions, and the impact of COVID-19, and to forecast future disease burden.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A multi-centre retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n A large hospital network with three maternity hospitals serving ethnically diverse populations in Melbourne, Australia.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Pregnant women who gave birth between 2016 and 2022.<\/jats:p>\n <\/jats:sec>\n \n Outcome measures<\/jats:title>\n Trends in cardiometabolic conditions, birth complications and obstetric interventions.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Over 7 years, 63\u2009232\u2009women were included, of whom 40% were nulliparous, and 60.9% were born overseas from 167 countries. From 2016\u20132022, maternal age (30.2\u201331.3 years), obesity (21.0%\u201326.2%), gestational diabetes mellitus (GDM) (15.9%\u201328.1%) and caesarean delivery (28.5%\u201337.6%) increased, while average gestational weight gain, premature births and special care admissions declined from 12.6\u201311.6\u2009kg, 6.3%\u20134.9% and 24.2%\u201314.1%, respectively; and was statistically significant (p<0.05). Hypertensive disorders of pregnancy remained stable, fluctuating slightly (6.5% in 2016, 7.6% in 2020, 6.9% in 2022). During the COVID-19 lockdown period, the odds of GDM and induced birth increased by 8.0%, whereas the odds of caesarean section decreased by 5.0%. GDM is forecast to reach 43.0% by 2028.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Prepregnancy and pregnancy cardiometabolic risk factors and conditions, pregnancy and birth complications, and obstetric interventions increased markedly over 7 years. Despite this, offspring complications, including special care admissions, stillbirths and prematurity, decreased, while pregnancy complications peaked during COVID-19. GDM is forecasted to increase to 43.0% by 2028, posing an unsustainable health and economic burden that necessitates urgent public health initiatives.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101777","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T07:01:05Z","timestamp":1761116465000},"page":"e101777","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in cardiometabolic conditions and pregnancy outcomes: a retrospective cohort study in South-Eastern Melbourne"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8984-1495","authenticated-orcid":false,"given":"Yitayeh","family":"Belsti","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7421-6291","authenticated-orcid":false,"given":"Kirsten R","family":"Palmer","sequence":"additional","affiliation":[{"name":"Monash Health, Clayton, Victoria, Australia"},{"name":"The Ritchie Centre at Hudson Institute of Medical Research, Clayton, Victoria, Australia"},{"name":"Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa J","family":"Moran","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2263-3592","authenticated-orcid":false,"given":"Daniel L","family":"Rolnik","sequence":"additional","affiliation":[{"name":"Monash Health, Clayton, Victoria, Australia"},{"name":"Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"},{"name":"Monash Health, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7356-4523","authenticated-orcid":false,"given":"Aya","family":"Mousa","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4480-5690","authenticated-orcid":false,"given":"Joanne","family":"Enticott","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena J","family":"Teede","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"},{"name":"Monash Health, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"unstructured":"OECD . 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