Maternal Characteristics, Pregnancy Complications, and Adverse Birth Outcomes Among Women With Disabilities

Mitra, Monika; Clements, Karen M.; Zhang, Jianying; Iezzoni, Lisa I.; Smeltzer, Suzanne C.; Long‐Bellil, Linda M.

doi:10.1097/mlr.0000000000000427

Cited by 110 publications

(119 citation statements)

References 29 publications

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“…This study was part of a larger mixed-method study of the unmet needs and barriers to perinatal care experienced by WWPD (Mitra et al, 2015a; 2016b). Other parts of the study included quantitative analysis of data from large national data sets and data obtained through surveys.…”

Section: Calloutmentioning

confidence: 99%

Perinatal Experiences of Women With Physical Disabilities and Their Recommendations for Clinicians

Smeltzer¹,

Mitra²,

Iezzoni³

et al. 2016

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Objective To explore the perinatal experiences of women with physical disabilities (WWPD) and their associated recommendations for maternity care clinicians to improve care. Design A mixed-method study was conducted using a semi-structured interview guide to identify the experiences of WWPD. This qualitative descriptive study is part of a larger study and was conducted to examine the perceptions of WWPD about their interactions with maternity care clinicians and their recommendations for maternity care clinicians to improve care. Participants Twenty-five women with physical disabilities who gave birth within the last 10 years and were 21–55 years of age were recruited and agreed to participate in the study. Methods Participants were asked about their interactions with clinicians during pregnancy and their recommendations for clinicians to improve perinatal care for women with physical disabilities. Transcribed interviews were analyzed using content analysis. Themes that emerged from analysis of the interviews were identified and coded. Kurasaski’s coding was used to establish the reliability of the coding. Results Three themes emerged from analysis of the interview data: clinicians’ lack of knowledge about pregnancy-related needs of WWPD; clinicians’ failure to consider knowledge, experience, and expertise of women about their own disabilities; and clinicians’ lack of awareness of reproductive concerns of WWPD. Women provided recommendations that warrant attention by clinicians who provide perinatal care for women who live with physical disabilities. Conclusion Participants experienced problematic interactions with clinicians related to pregnancy and identified recommendations for maternity care clinicians to address those problems with the goal of improving perinatal health care for WWPD.

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Section: Calloutmentioning

confidence: 99%

Perinatal Experiences of Women With Physical Disabilities and Their Recommendations for Clinicians

Smeltzer¹,

Mitra²,

Iezzoni³

et al. 2016

Journal of Obstetric, Gynecologic & Neonatal Nursing

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“…However, utilization of prenatal care is lower among women with disabilities (Gavin, Benedict, & Adams, 2006). While limited evidence suggests that many women with disabilities have favorable pregnancy outcomes (Signore, et al, 2011), studies have shown higher rates of preterm birth and low birth weight in this population (Mitra, Clements, et al, 2015). Further, increased cesarean delivery has been documented among women with specific types of physical disability, including spinal cord injury, rheumatoid arthritis, multiple sclerosis, cerebral palsy, spina bifida, and neuromuscular disorders (Arata, Grover, Dunne, & Bryan, 2000; Argov & de Visser, 2009; Chakravarty, Nelson, & Krishnan, 2006; Chambers, Johsnon, & Jones, 2004; Kelly, Nelson, & Chakravarty, 2009; Rudnik-Schoneborn & Zerres, 2004; Skomsvoll, Ostensen, Irgens, & Baste, 1998; Winch, Bengston, McLaughlin, Fitzsimmons, & Budden, 1993).…”

Section: Introductionmentioning

confidence: 99%

Primary Cesarean Delivery Patterns among Women with Physical, Sensory, or Intellectual Disabilities

Darney

Biel

Quigley

et al. 2017

Women's Health Issues

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INTRODUCTION Little is known about the relationship between disability and mode of delivery. Prior research has indicated elevated risk of cesarean delivery among women with certain disabilities, but has not examined patterns across multiple types of disability or by parity. OBJECTIVE To determine whether physical, sensory, or intellectual and developmental disabilities are independently associated with primary cesarean delivery. METHODS We conducted a retrospective cohort study of all deliveries in California 2000–2010 using linked birth certificate and hospital discharge data. We identified physical, sensory, and intellectual and developmental disabilities using ICD-9 codes. We used logistic regression to examine the association of these disabilities and primary cesarean delivery, controlling for socio-demographic characteristics and co-morbidities and stratified by parity. RESULTS In our sample, 0.45% (20,894/4,610,955) of deliveries were to women with disabilities. A larger proportion of women with disabilities were nulliparous, had public insurance, and had co-morbidities (e.g., gestational diabetes) compared with women without disabilities (p<0.001 for all). The proportion of primary cesarean in women with disabilities was twice that in women without disabilities (32.7% versus 16.3%, p<0.001; aOR = 2.05; 95% CI = 1.94–2.17). The proportion of deliveries by cesarean was highest among women with physical disabilities due to injuries compared with women without disabilities (57.8% versus 16.3%, p<0.001; aOR = 6.83; 95%CI = 5.46–8.53). CONCLUSION Women across disability subgroups have higher odds of cesarean delivery, and there is heterogeneity by disability type. More attention is needed to this population to ensure better understanding of care practices that may impact maternal and perinatal outcomes.

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“…While women with disabilities still constitute a small proportion of women giving birth [3, 4], that proportion may be growing. However, no empirical data have been published on changes over time in the numbers of women with disabilities giving birth.…”

Section: Introductionmentioning

confidence: 99%

Time trends in births and cesarean deliveries among women with disabilities

Horner‐Johnson

Biel

Darney

et al. 2017

Disability and Health Journal

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Background Although it is likely that childbearing among women with disabilities is increasing, no empirical data have been published on changes over time in the numbers of women with disabilities giving birth. Further, while it is known that women with disabilities are at increased risk of cesarean delivery, temporal trends in cesarean deliveries among women with disabilities have not been examined. Objective To assess time trends in births by any mode and in primary cesarean deliveries among women with physical, sensory, or intellectual/developmental disabilities. Methods We conducted a retrospective cohort study using linked vital records and hospital discharge data from all deliveries in California, 2000–2010 (n=4,605,061). We identified women with potential disabilities using ICD-9 codes. We used descriptive statistics and visualizations to examine time patterns. Logistic regression analyses assessed the association between disability and primary cesarean delivery, stratified by year. Results Among all women giving birth, the proportion with a disability increased from 0.27% in 2000 to 0.80% in 2010. Women with disabilities had significantly elevated odds of primary cesarean delivery in each year, but the magnitude of the odds ratio decreased over time from 2.60 (95% CI=2.25=2.99) in 2000 to 1.66 (95% CI=1.51–1.81) in 2010. Conclusions Adequate clinician training is needed to address the perinatal care needs of the increasing numbers of women with disabilities giving birth. Continued efforts to understand cesarean delivery patterns and reasons for cesarean deliveries may help guide further reductions in proportions of cesarean deliveries among women with disabilities relative to women without disabilities.

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Maternal Characteristics, Pregnancy Complications, and Adverse Birth Outcomes Among Women With Disabilities

Cited by 110 publications

References 29 publications

Perinatal Experiences of Women With Physical Disabilities and Their Recommendations for Clinicians

Perinatal Experiences of Women With Physical Disabilities and Their Recommendations for Clinicians

Primary Cesarean Delivery Patterns among Women with Physical, Sensory, or Intellectual Disabilities

Time trends in births and cesarean deliveries among women with disabilities

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