{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:02:41Z","timestamp":1758758561719,"version":"3.44.0"},"reference-count":34,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021096","name":"The George Institute for Global Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100021096","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,28]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The co-occurrence of multiple long-term conditions, that is, multimorbidity, is increasing globally and is associated with lower quality of life and increased risk of death. The risk and prevalence of multimorbidity are higher among women compared with men, but currently, evidence focusing on women\u2019s multiple long-term conditions during the perinatal period is limited. Existing evidence needs to be examined to determine the extent to which maternal multimorbidity or women\u2019s multiple health needs related to pregnancy have been addressed, especially for women living in low-income and middle-income countries (LMICs) where this burden of disease is the highest. The objective of this scoping review is to map existing evidence in LMICs on (a) Study designs and data sources, (b) Context-relevant definitions and descriptions, (c) Associated risk and protective factors, (d) Relevant maternal and infant health outcomes and (e) Treatments and interventions used to manage multiple long-term conditions before, during and after pregnancy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>This scoping review will be conducted using Joanna Briggs Institute methodology and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement extension for scoping reviews. This review will include observational, experimental or quasi-experimental studies, as well as systematic or umbrella reviews, on multimorbidity in women of reproductive age (15\u201349 years) in prepregnancy, pregnancy or up to 6\u2009weeks after childbirth in LMICs. The studies will focus on definitions, risk and protective factors and management strategies for multiple long-term conditions before, during and after pregnancy. Studies of morbidity in women with a single index condition or conditions that are not related to pregnancy or childbirth will be excluded. A search strategy will be developed using thesaurus (including MeSH) and free-text terms for \u2018maternal morbidity\u2019 or \u2018multiple long-term conditions\u2019 and associated keywords such as multimorbidity, co-morbidity and unmet health needs related to pregnancy and\/or childbirth for women living in LMICs. Electronic (EBSCOhost (CINAHL Ultimate, STM Source, Medline Ultimate), Cochrane Library, Web of Science or Scopus and Google Scholar) and grey literature databases will be searched from database inception. Reference lists and bibliographies of key topic articles will also be searched, and any additional papers that meet the inclusion criteria will be obtained. There will be no limitations on dates or languages. Records will be independently screened, selected and extracted by two researchers. Data will be presented in tables and narrative summaries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Ethics approval is not required as this scoping review will summarise previously published data. Findings from the review will be disseminated through various platforms, including peer-reviewed journals, conferences and community meetings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study registration<\/jats:title>\n                  <jats:p>Open Science Framework (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.17605\/OSF.IO\/FYCR8\">https:\/\/doi.org\/10.17605\/OSF.IO\/FYCR8<\/jats:ext-link>).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-104565","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T03:01:51Z","timestamp":1758682911000},"page":"e104565","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Multimorbidity before, during and after pregnancy among women in low-income and middle-income countries: protocol for a scoping review"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9596-1909","authenticated-orcid":false,"given":"Vundli","family":"Ramokolo","sequence":"first","affiliation":[{"name":"HIV and Other Infectious Disease Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3267-8484","authenticated-orcid":false,"given":"Rifqah A","family":"Roomaney","sequence":"additional","affiliation":[{"name":"Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique","family":"Maqungo","sequence":"additional","affiliation":[{"name":"Burden of Disease Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1839-877X","authenticated-orcid":false,"given":"Makandwe","family":"Nyirenda","sequence":"additional","affiliation":[{"name":"Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, South Africa"},{"name":"School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parul","family":"Puri","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health India, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5385-0143","authenticated-orcid":false,"given":"Kenneth","family":"Yakubu","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Sydney, New South Wales, 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