1 Vol.:(0123456789) Scientific Reports | (2024) 14:571 | https://doi.org/10.1038/s41598-023-51122-z www.nature.com/scientificreports Evaluating the effect of maternal non‑communicable disease on adverse pregnancy outcomes and birthweight in Pakistan, a facility based retrospective cohort study Esther Wainwright 1 , Irfan Sheikh 2 , Rahat Qureshi 2 , Sana Yousuf 2 , Raheela Khan 3 & Matthew Elmes 1* Non‑communicable diseases (NCDs) claim 74% of global lives, disproportionately affecting lower and middle‑income countries like Pakistan. NCDs may increase the risk of preterm birth (PTB), caesarean section (CS), and low birthweight. This study aims to determine whether the high prevalence of NCDs in Pakistan play a role in the high rates of preterm births, and CS. This retrospective cohort study from Aga Khan University Hospital, Pakistan, investigated effects of pre‑existing NCDs on pregnancy outcomes of 817 pregnant women. Medical records were used to generate odds ratios for the risk of PTB, labour outcome and birthweight in women with type 1 and type 2 diabetes, hypertension, asthma and thyroid disorders. Multinomial logistic regression and general linear models were used to adjust for confounding variables using IBM SPSS Statistics (v27). Type 2 diabetes significantly increased the risk of PTB and elective CS (both P < 0.05). Elective CS was significantly increased by hypertension and asthma (both, P < 0.05). Surprisingly, asthma halved the risk of PTB (P < 0.05), while type 1 diabetes significantly increased birthweight from 2832 to 3253g (P < 0.001). In conclusion, pre‑existing NCDs increase the risk of negative pregnancy outcomes, including PTB, elective CS and birthweight. Asthma, however reduced PTB and justifies further investigation. Abbreviations NCDs Non-communicable diseases CS Caesarean sections PTB Preterm birth LMICs Low middle Income countries cOR Crude odds ratio aOR Adjusted odds ratio Background Poor birth outcomes, including preterm birth (PTB) and low birth weight (LBW) are a major public health problem across the world, particularly in lower- and middle-income countries (LMICs) such as Pakistan. Central and southern Asia account for 17% of all maternal deaths worldwide with maternal mortality rates for southern Asia estimated to be 134 per 100,000 live births 1 . Complications of pregnancy and childbirth remains the lead- ing cause of death and disability for childbearing women in Pakistan 2 . Preterm birth (born before 37 weeks’ OPEN 1 Division of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough LE12 5RD, UK. 2 Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan. 3 School of Medicine, Royal Derby Hospital Centre, University of Nottingham, Translational Medical Sciences Unit, Derby DE22 3DT, UK. * email: matthew.elmes@nottingham.ac.uk