Rapid repeat pregnancy among women with intellectual and developmental disabilities: a population-based cohort study

Brown, Hilary K.; Ray, Joel G.; Liu, Ning; Lunsky, Yona; Vigod, Simone N.

doi:10.1503/cmaj.170932

Cited by 19 publications

(6 citation statements)

References 31 publications

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“…Various comorbid conditions, such as thyroid, musculoskeletal and cardiac problems may lead to a high-risk pregnancy. A cohort study by Hilary K. Brown et al in 2018 also reported a higher rate of rapid repeat pregnancy within one year among IDW ( 16 ).…”

Section: Resultsmentioning

confidence: 99%

Challenges in Providing Reproductive and Gynecologic Care to Women with Intellectual Disabilities: A Review of Existing Literature

Shrestha¹,

Ishak²,

Maskey³

et al. 2022

JFRH

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Objective: Our review aims to focus on identifying challenges faced by intellectually disabled women (IDW) in receiving gynecological and reproductive care and also highlights evidence based strategies to overcome those challenges. Materials and methods: We conducted a literature review discussing challenges faced by IDW in obtaining healthcare services by thorough search on various electronic databases (PubMed, Google Scholar, and Scopus) starting from 2000 to 28 August 2021 excluding all non-english articles, reviews, editorials and letters to editor. The keywords used for search were “reproductive care”, “gynecologic care”, “intellectual disability”, “mental handicap”, and "mental retardation". Results: The existing literature review showed that IDW have difficulty maintaining menstrual hygiene and lack knowledge regarding contraception use and sexual health resulting in violations of their reproductive rights. Sexually transmitted diseases and cervical cancer are common among IDW due to their vulnerability to sexual abuse. Nulliparity in IDW increases their suspectibility to even breast cancer. Moreover, they face problems with sexually transmitted infection (STI) and cancer screening due to physical barriers for assessment, low socio-economic status, physician-patient communication issues and deficit in skilled providers. Short acting sedatives such as ketamine or midazolam can be used to overcome challenges faced with gynecological and obstetric examination. Finally forced sterilization and institutionalization has been a habitual practice as menstrual hygiene and pregnancy in IDW raise concerns on psychosocial challenges along with associated obstetric complications. Conclusion: Reproductive and sexual health education including contraception use can be provided by using evidence based strategies involving use of pictures, animations and models by adequately trained healthcare providers including midwives. Further research involving IDW is needed to allow state-wise laws and policies to be created to mitigate the challenges and improve health outcomes in this population.

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Section: Resultsmentioning

confidence: 99%

Challenges in Providing Reproductive and Gynecologic Care to Women with Intellectual Disabilities: A Review of Existing Literature

Shrestha¹,

Ishak²,

Maskey³

et al. 2022

JFRH

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“…[27][28][29] Intellectual disability is associated with heightened risk of a range of adverse pregnancy and birth outcomes. [30][31][32][33][34] In addition, intellectual disability is associated with differences in many domains of parenting, including heightened parenting stress, lower caregiving sensitivity related to adults' own experiences of childhood maltreatment, elevated rates of mental health difficulties and decreased social support that influence parenting, and over-representation within the CPS system. 14,[35][36][37][38][39][40] Given the high co-occurrence of intellectual disability with autism, autistic adults, especially those who are not speaking and/or have cognitive differences, may share similar pregnancy and parenthood experiences.…”

mentioning

confidence: 99%

Pregnancy and Parenthood Among Autistic Adults: Implications for Advancing Maternal Health and Parental Well-Being

McDonnell

DeLucia

2021

Autism in Adulthood

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Background: Strikingly little research has considered how autistic adults experience pregnancy and parenthood, two key transition periods in adult development with potentially far-reaching implications for physical and psychosocial health outcomes across the lifespan. This article reviews the research on pregnancy and parenthood among autistic adults, to summarize existing research and identify future directions to advance this critical area of study. Methods: We conducted a systematic review of the literature on pregnancy and parenthood among autistic adults. Researchers extracted selected articles for key information, including methodology and sample size, study location, demographic characteristics of participants, measurement approaches, and key study findings. Results: Overall, we identified 13 studies that used a range of quantitative and qualitative approaches to study pregnancy experiences and outcomes and parenthood among autistic adults. The findings show that autistic adults (1) experience difficulties and dissatisfaction communicating with health care providers throughout pregnancy and birth, (2) are more likely to experience depression during and after pregnancy, and (3) experience higher rates of pregnancy complications, including preterm birth, cesarean delivery, and pre-eclampsia. During parenthood, autistic adults report lower parenting competence, experience parenthood as isolating, have difficulty communicating with professionals about their child and are questioned by providers about their ability to parent, experience high rates of involvement with child protective services, and express a desire for increased parenting support. Autistic adults also reported parenting strengths, including high levels of finding parenthood rewarding and putting their children's needs ahead of their own. Conclusions: A key limitation of the literature is the significant lack of sociodemographic diversity among participants, the small number of existing studies, and reliance on cross-sectional mono-method designs. Future research should be conducted in partnership with autistic adults to develop assessment and intervention approaches for supporting pregnancy health and parental well-being among diverse and underserved communities.

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“…Women with ID who became pregnant tended to have the following characteristics: they were under 20 years old; they were living in low-income neighborhoods and rural areas; their ethnicity was non-Hispanic Black or Hispanic; they had public health insurance; and they were not married [ 134 , 135 , 140 , 143 , 144 , 145 , 150 , 155 , 156 , 158 ]. They were also at increased risk for rapid repeat pregnancy within a year of a live birth [ 144 ].…”

Section: Resultsmentioning

confidence: 99%

The Right to Sexuality, Reproductive Health, and Found a Family for People with Intellectual Disability: A Systematic Review

Pérez-Curiel

Sánchez

Morán

et al. 2023

IJERPH

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Although sexuality, reproductive health, and starting a family are human rights that should be guaranteed for all citizens, they are still taboo issues for people with intellectual disability (ID), and even more so for women with ID. This paper systematically reviews the current qualitative and quantitative evidence on the rights of people with ID in regard to Articles 23 (right to home and family) and 25 (health, specifically sexual and reproductive health) of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the current literature, following PRISMA 2020, was carried out in ERIC, PsychInfo, Scopus, PubMed, ProQuest, and Web of Science. In all, 151 articles were included for review. The studies were categorized into six themes: attitudes, intimate relationships, sexual and reproductive health, sexuality and sex education, pregnancy, and parenthood. There are still many barriers that prevent people with ID from fully exercising their right to sexuality, reproductive health, and parenthood, most notably communicative and attitudinal barriers. These findings underline the need to continue advancing the rights of people with ID, relying on Schalock and Verdurgo’s eight-dimensional quality of life model as the ideal conceptual framework for translating such abstract concepts into practice and policy.

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Rapid repeat pregnancy among women with intellectual and developmental disabilities: a population-based cohort study

Cited by 19 publications

References 31 publications

Challenges in Providing Reproductive and Gynecologic Care to Women with Intellectual Disabilities: A Review of Existing Literature

Challenges in Providing Reproductive and Gynecologic Care to Women with Intellectual Disabilities: A Review of Existing Literature

Pregnancy and Parenthood Among Autistic Adults: Implications for Advancing Maternal Health and Parental Well-Being

The Right to Sexuality, Reproductive Health, and Found a Family for People with Intellectual Disability: A Systematic Review

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