{
  "abstract": "Introduction 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’s 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’s 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.Methods and analysis 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 (15–49 years) in prepregnancy, pregnancy or up to 6 weeks 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 ‘maternal morbidity’ or ‘multiple long-term conditions’ 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.Ethics and dissemination 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.Study registration Open Science Framework ( https://doi.org/10.17605/OSF.IO/FYCR8).",
  "authors": [
    {
      "affiliations": [
        "HIV and Other Infectious Disease Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa"
      ],
      "name": "Vundli Ramokolo"
    },
    {
      "affiliations": [
        "Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, Western Cape, South Africa"
      ],
      "name": "Rifqah A Roomaney"
    },
    {
      "affiliations": [
        "Burden of Disease Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa"
      ],
      "name": "Monique Maqungo"
    },
    {
      "affiliations": [
        "Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, South Africa",
        "School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa"
      ],
      "name": "Makandwe Nyirenda"
    },
    {
      "affiliations": [
        "The George Institute for Global Health India, New Delhi, Delhi, India"
      ],
      "name": "Parul Puri"
    },
    {
      "affiliations": [
        "The George Institute for Global Health, Sydney, New South Wales, Australia"
      ],
      "name": "Kenneth Yakubu"
    },
    {
      "affiliations": [
        "The George Institute for Global Health, Hyderabad, India",
        "Manipal Academy of Higher Education, Manipal, India"
      ],
      "name": "Balaji Gummidi"
    },
    {
      "affiliations": [
        "Health Systems Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa"
      ],
      "name": "Wanga Zembe-Mkabile"
    },
    {
      "affiliations": [
        "School of Public Health and School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China",
        "The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Xiaolin Xu"
    },
    {
      "affiliations": [
        "Queen Elizabeth Central Hospital, Blantyre, Malawi",
        "University of Liverpool, Liverpool, UK"
      ],
      "name": "Mary McCauley"
    }
  ],
  "title": "Multimorbidity before, during and after pregnancy among women in low-income and middle-income countries: protocol for a scoping review",
  "uid": "ef49ed5b-9a5c-5148-9b9e-481db2ac73a2"
}