Pregnancy Outcomes Among Women with Intellectual and Developmental Disabilities

Mitra, Monika; Parish, Susan L.; Clements, Karen M.; Cui, Xiaohui; Diop, Hafsatou

doi:10.1016/j.amepre.2014.09.032

Cited by 98 publications

(81 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study makes a contribution to the literature by showing an elevated occurrence of labour inductions in this population. Only three studies have examined the occurrence of caesarean sections in women with IDD 13 14 16. While our findings are consistent with those of the American13 and Swedish14 studies, the magnitude of the effect in our study was smaller.…”

Section: Discussionsupporting

confidence: 87%

“…Only three studies have examined the occurrence of caesarean sections in women with IDD 13 14 16. While our findings are consistent with those of the American13 and Swedish14 studies, the magnitude of the effect in our study was smaller. This difference could be because our study sample was more representative due to the use of linked health and social services administrative data or because we controlled for important confounding variables.…”

Section: Discussionsupporting

confidence: 87%

“…Like this latter study,16 we did not find an elevated occurrence of operative vaginal delivery among women with IDD. These previous studies hypothesised that labour and delivery interventions in this population were explained by pre-existing health conditions and pregnancy complications 13 14. Until now, this assertion had not been formally tested.…”

Section: Discussionmentioning

confidence: 96%

“…However, no studies have examined labour induction, and the few that have examined caesarean section and operative vaginal delivery are inconclusive. A retrospective cohort study from the USA found that women with IDD (N=703) were more likely than those without to have caesarean sections (relative risk RR, 1.3; 95% CI 1.2 to 1.5) 13. A Swedish retrospective cohort study (N=340 with IDD) found similar results (adjusted OR, 1.6; 95% CI 1.2 to 2.2) 14.…”

Section: Introductionmentioning

confidence: 91%

See 3 more Smart Citations

Labour and delivery interventions in women with intellectual and developmental disabilities: a population-based cohort study

Brown¹,

Kirkham

Cobigo

et al. 2015

J Epidemiol Community Health

View full text Add to dashboard Cite

Women with intellectual and developmental disabilities are slightly more likely to have labour inductions and caesarean sections than women without intellectual and developmental disabilities. The elevated occurrence of these interventions is not fully explained by their pre-pregnancy health conditions or pregnancy complications. Non-medical issues should be evaluated for their influence on the timing of labour and delivery in this population.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 91%

See 2 more Smart Citations

Labour and delivery interventions in women with intellectual and developmental disabilities: a population-based cohort study

Brown¹,

Kirkham

Cobigo

et al. 2015

J Epidemiol Community Health

View full text Add to dashboard Cite

show abstract

“…The disparities observed in women with IDD during the prenatal period12 suggest that the postpartum needs of this population may not be adequately addressed. The greater likelihood of ED visits among women with IDD could be associated with poorly communicated or inadequate postpartum discharge instructions.…”

Section: Discussionmentioning

confidence: 99%

Postpartum emergency department use among women with intellectual and developmental disabilities: a retrospective cohort study

Mitra

Akobirshoev

Parish

et al. 2019

J Epidemiol Community Health

Self Cite

View full text Add to dashboard Cite

BackgroundAn emerging body of evidence underscores the often-intensive perinatal healthcare needs of women with intellectual and developmental disabilities (IDD). However, population-based research examining postpartum experiences of US women with IDD is sparse. We examined emergency department (ED) use in the postpartum period among Massachusetts mothers with IDD.MethodsWe analysed 2002–2010 Massachusetts Pregnancy to Early Life Longitudinal data to compare any and ≥2 ED visits between mothers with and without IDD: within 1–42 days post partum, 1–90 days post partum and 1–365 days post partum. We also determined whether or not such ED use was non-urgent or primary-care sensitive.ResultsWe identified 776 births in women with IDD and 595 688 births in women without IDD. Across all three postpartum periods, women with IDD were vastly more likely to have any postpartum ED use, to have ≥2 ED visits and to have ED visits for mental health reasons. These findings persisted after controlling for numerous sociodemographic and clinical characteristics. Women with IDD were less likely to have non-urgent ED visits during the three postpartum periods and they were less likely to have primary-care sensitive ED visits during the postpartum period.ConclusionThese findings contribute to the emerging research on perinatal health and healthcare use among women with IDD. Further research examining potential mechanisms behind the observed ED visit use is warranted. High ED use for mental health reasons among women with IDD suggests that their mental health needs are not being adequately met.

show abstract

Perinatal and Postpartum Health Among People With Intellectual and Developmental Disabilities

Shea,

Sadowsky,

Tao

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceSmall, geographically limited studies report that people with intellectual and developmental disabilities (IDD) have increased risk for serious pregnancy-related and birth-related challenges, including preeclampsia, preterm birth, and increased anxiety and depression, than their peers. United States–based population-level data among people with IDD are lacking.ObjectivesTo identify perinatal and postpartum outcomes among a national, longitudinal sample of people with IDD enrolled in public health insurance, compare subgroups of people with IDD, and compare outcomes among people with IDD with those of peers without IDD.Design, Setting, and ParticipantsThis retrospective cohort study used national Medicaid claims from January 1, 2008, to December 31, 2019, for 55 440 birthing people with IDD and a random sample of 438 557 birthing people without IDD. Medicaid funds almost half of all births and is the largest behavioral health insurer in the US, covering a robust array of services for people with IDD. Statistical analysis was performed from July 2023 to June 2024.ExposurePeople who had a documented birth in Medicaid during the study years.Main Outcome and MeasuresPerinatal outcomes were compared across groups using univariate and multivariate logistic regression. The probability of postpartum anxiety and depression was estimated using Kaplan-Meier and Cox proportional hazards regression.ResultsThe study sample included 55 440 birthing people with IDD (including 41 854 with intellectual disabilities [ID] and 13 586 with autism; mean [SD] age at first delivery, 24.9 [6.7] years) and a random sample of 438 557 birthing people without IDD (mean [SD] age at first delivery, 26.4 [6.3] years). People with IDD were younger at first observed delivery, had a lower prevalence of live births (66.6% vs 76.7%), and higher rates of obstetric conditions (gestational diabetes, 10.3% vs 9.9%; gestational hypertension, 8.7% vs 6.1%; preeclampsia, 6.1% vs 4.4%) and co-occurring physical conditions (heart failure, 1.4% vs 0.4%; hyperlipidemia, 5.3% vs 1.7%; ischemic heart disease, 1.5% vs 0.4%; obesity, 16.3% vs 7.4%) and mental health conditions (anxiety disorders, 27.9% vs 6.5%; depressive disorders, 32.1% vs 7.5%; posttraumatic stress disorder, 9.5% vs 1.2%) than people without IDD. The probability of postpartum anxiety (adjusted hazard ratio [AHR], 3.2 [95% CI, 2.9-3.4]) and postpartum depression (AHR, 2.4 [95% CI, 2.3-2.6]) was significantly higher among autistic people compared with people with ID only and people without IDD.Conclusions and RelevanceIn this retrospective cohort study, people with IDD had a younger mean age at first delivery, had lower prevalence of live births, and had poor obstetric, mental health, and medical outcomes compared with people without IDD, pointing toward a need for clinician training and timely delivery of maternal health care. Results highlight needed reproductive health education, increasing clinician knowledge, and expanding Medicaid to ensure access to care for people with IDD.

show abstract

Pregnancy Outcomes Among Women with Intellectual and Developmental Disabilities

Cited by 98 publications

References 36 publications

Labour and delivery interventions in women with intellectual and developmental disabilities: a population-based cohort study

Labour and delivery interventions in women with intellectual and developmental disabilities: a population-based cohort study

Postpartum emergency department use among women with intellectual and developmental disabilities: a retrospective cohort study

Perinatal and Postpartum Health Among People With Intellectual and Developmental Disabilities

Contact Info

Product

Resources

About