Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT, USA.
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
BMC Pregnancy Childbirth. 2022 Oct 22;22(1):787. doi: 10.1186/s12884-022-05047-6.
Non-communicable diseases [NCDs] are leading causes of ill health among women of reproductive age and an increasingly important cause of maternal morbidity and mortality worldwide. Reliable data on NCDs is necessary for accurate measurement and response. However, inconsistent definitions of NCDs make reliable data collection challenging. We aimed to map the current global literature to understand how NCDs are defined, operationalized and discussed during pregnancy, childbirth and the postnatal period. METHODS: For this scoping review, we conducted a comprehensive global literature search for NCDs and maternal health covering the years 2000 to 2020 in eleven electronic databases, five regional WHO databases and an exhaustive grey literature search without language restrictions. We used a charting approach to synthesize and interpret the data. RESULTS: Only seven of the 172 included sources defined NCDs. NCDs are often defined as chronic but with varying temporality. There is a broad spectrum of conditions that is included under NCDs including pregnancy-specific conditions and infectious diseases. The most commonly included conditions are hypertension, diabetes, epilepsy, asthma, mental health conditions and malignancy. Most publications are from academic institutions in high-income countries [HICs] and focus on the pre-conception period and pregnancy. Publications from HICs discuss NCDs in the context of pre-conception care, medications, contraception, health disparities and quality of care. In contrast, publications focused on low- and middle-income countries discuss NCDs in the context of NCD prevention. They take a life cycle approach and advocate for integration of NCD and maternal health services.
Standardising the definition and improving the articulation of care for NCDs in the maternal health setting would help to improve data collection and facilitate monitoring. It would inform the development of improved care for NCDs at the intersection with maternal health as well as through a woman's life course. Such an approach could lead to significant policy and programmatic changes with the potential corresponding impact on resource allocation.
非传染性疾病（NCDs）是导致育龄妇女健康不良的主要原因，也是全球孕产妇发病率和死亡率日益增加的重要原因。可靠的 NCD 数据对于准确的测量和应对是必要的。然而，NCD 的定义不一致使得可靠的数据收集具有挑战性。我们旨在绘制当前全球文献图谱，以了解 NCD 在妊娠、分娩和产后期间是如何定义、实施和讨论的。
在本次范围界定审查中，我们在十一个电子数据库、五个世界卫生组织区域数据库和一个无语言限制的详尽灰色文献搜索中，对 2000 年至 2020 年期间涵盖 NCD 和孕产妇健康的全球文献进行了全面搜索。我们使用图表方法来综合和解释数据。
在纳入的 172 个来源中，仅有 7 个定义了 NCD。NCD 通常被定义为慢性疾病，但具有不同的时间性。包括与妊娠相关的疾病和传染病在内，有广泛的疾病包括在 NCD 中。最常包括的疾病有高血压、糖尿病、癫痫、哮喘、心理健康状况和恶性肿瘤。大多数出版物来自高收入国家的学术机构，重点关注孕前和妊娠。来自高收入国家的出版物从孕前保健、药物、避孕、健康差距和护理质量的角度讨论 NCD。相比之下，关注中低收入国家的出版物则从 NCD 预防的角度讨论 NCD。它们采用生命周期方法，倡导将 NCD 和孕产妇保健服务相结合。
标准化 NCD 在孕产妇保健环境中的定义和改善护理方法，将有助于改善数据收集并促进监测。这将为改善 NCD 与孕产妇健康的交叉处的护理以及通过女性的生命历程提供信息。这种方法可能会导致重大的政策和方案变化，从而有可能相应地影响资源分配。
