贯穿整个生命历程的整合

Bridging noncommunicable diseasesand sexual, reproductive, maternal,newborn, child and adolescent health © UNFPA, September 2025Start With Herpolicy brief seriesProduced by the UNFPA Maternal & Newborn Health Fund Cover image© UNFPA Noncommunicable diseasesare responsible for more than60% of global mortality. NCDs are the leading cause of premature death worldwideand a major threat among women of reproductive age. based bundles of obstetric and newborn care.However, indirect obstetric deaths – maternaldeaths from pre-existing conditions or fromdiseases that develop during pregnancy andare exacerbated by its physiological changes –accounted for over a quarter of maternal mortalityworldwide between 2009 and 2020.8This shift,where the relative proportion of indirect deathsgrows as direct deaths decline, is known as theobstetric transition. As countries make progressin addressing direct causes of maternal mortality,the impact of NCDs and other indirect causesbecomes more apparent.9 Noncommunicable diseases (NCDs) killed over43 million people in 2021, equivalent to three-quarters of all non-pandemic-related deathsglobally. About 18 million NCD deaths wereamong people younger than 70 years of age– more than all injuries, infections includingCOVID-19, and maternal and nutritional causesof death combined1. Of these deaths, the vastmajority – 82 per cent – occured in low- andmiddle-income countries2. Overall, 73 per cent of all noncommunicabledisease deaths are concentrated in thesecountries, where health systems are the weakest.3Preventing, detecting, and managing NCDs is acritical global health priority, as highlighted inTarget 3.4 of the Sustainable Development Goals(SDGs).4 While the transition is most pronounced inhigh-income countries, it is rapidly emerging inlow- and middle-income countries, where healthsystems are least prepared to manage it. Theresult is a dual burden: progress in managingcommon maternal complications is compoundedby the rising tide of NCDs, demanding urgentintegration of NCD prevention, detection andmanagement within sexual, reproductive,maternal, newborn, child and adolescent healthservices. NCDS are a major threat among women ofreproductive age The strong interlinkages between NCDs andsexual, reproductive, maternal, newborn, child andadolescent health are increasingly evident. NCDsare now a major threat across all populations, andtheir burden among women of reproductive ageis rising. The proportion of deaths among womenaged 15–49 caused by NCDs increased morethan 5 per cent between 2000 and 2021.5Giventhat 80 to 90 per cent of women conceive in theirlifetimes6, the intersection between pregnancyand NCDs is unavoidable. Pregnancy and NCDs Pregnancy can exacerbate pre-existing NCDs,heightening risks for both mother and child.10Gestational diabetes, the most common medicalcomplication of pregnancy, affects approximately1 in 6 pregnant women worldwide.11It increasesimmediate risks such as pre-eclampsia, whilealso predicting longer-term health issuessuch as type 2 diabetes and cardiovasculardisease. Other common conditions in pregnancyinclude asthma, cardiac disorders, epilepsy,and mental health or substance use disorders. The obstetric transition More than 70 per cent of global maternal deathsresult from direct obstetric complications suchas haemorrhage and infections.7Care for thesecomplications has improved through evidence- Although NCDs are common, they can remainundiagnosed in pregnancy, and their impactmay not be appreciated until complicationsoccur, for instance, a stillbirth. This highlight amissed opportunity to deliver high-quality careand improve the health of the woman and hernewborn. Sexual and reproductive health servicesare also critical entry points for prevention. Forexample, access to family planning reduces high-risk pregnancies, prevents complications, andempowers women and adolescents to exercisetheir right to decide if and when to have children. Mental health Post-partum depression is a serious but oftenoverlooked NCD. It affects around 13 per centof women globally after childbirth15, with ratesas high as 20 per cent in low- and middle-income countries.16Integrating care duringpregnancy and post-partum, including linkingpostnatal follow-up with newborn and childhealth programmes, is essential to breaking theintergenerational cycle of ill health.17 Exposure to NCD risk factors during pregnancy,including tobacco use, alcohol use, unhealthydiet, physical inactivity and air pollution, in turnshaped by social determinants, heightens the riskof miscarriage, stillbirth and other complications.These risks accumulate across a woman’s lifecourse, worsening outcomes the longer theyremain unmanaged.12For newborns, NCDscan trigger premature birth, low birth weight,congenital malformations and respiratory distress,entrenching poor health outcomes acrossgenerations.13 1 in 6pregnant women experiencegestational diabetes Adolescence and the early reproductive years