To fill this gap, maternal morbidity needs to be clearly defined, driving the development of tools and indicators to measure and monitor maternal health.
26 For these patients, the risk of significant long-term neurologic morbidity needs to be carefully considered against the benefit of aggressive surgery to achieve gross total resection.
Maternal mortality and morbidity needs to be addressed with a wide range of interventions and progress is dependent on the capacity of the health system to implement policy.
When measuring the health situation in the populations with the ACG system, the time span of the constellation of morbidity needs to be discussed.
Hysterectomy at the time of BSO is controversial, and the additional morbidity needs to be taken into account and weighed against the potential risks of combined HT for the management of menopausal symptoms and bone protection.
The lack of significant differences in the incidence of any of these morbidities, need to taken with caution.
Consequently, any policy initiatives or guidelines on multi-morbidity need to be relevant at a much earlier age in people with intellectual disabilities.
At a clinical level, it may mean that such patient with high levels of medical co-morbidity need to be assessed differently, perhaps screened more rigorously for the presence of cognitive deficits, or the physician may need to make a greater effort to contact collateral sources.
The reasons for death, or relapse or other morbidities need to be understood, and deaths are likely when medical care and treatment are inaccessible.
To understand the effect of deprivation on morbidity, and whether there are public health opportunities related to tackling neighbourhood deprivation to improve health, the separate effects of individual and neighbourhood deprivation on different morbidities need to be ascertained.
