Background Approximately 12% of women of reproductive age have some type of disability. Very little is known about sexual and reproductive health issues among women with disabilities, including what proportion of women with disabilities experience pregnancy. Data on pregnancy are important to inform needs for preconception and pregnancy care for women with disabilities. Objective The purpose of this study was to describe the occurrence of pregnancy among women with various types of disability and with differing levels of disability complexity, compared to women without disabilities, in a nationally representative sample. Study Design We conducted cross-sectional analyses of 2008–2012 Medical Expenditure Panel Survey annualized data to estimate the proportion of women ages 18–44 with and without disabilities who reported a pregnancy during one year of their participation on the survey panel. We used multivariable logistic regression to test the association of pregnancy with presence, type, and complexity of disability, controlling for other factors associated with pregnancy. Results Similar proportions of women with and without disabilities reported a pregnancy (10.8% vs. 12.3%, with 95% confidence intervals overlapping). Women with the most complex disabilities (those that impact activities such as self-care and work) were less likely to have been pregnant (AOR=0.69, 95%CI=0.52–0.93), but women whose disabilities only affected basic actions (seeing, hearing, movement, cognition) did not differ significantly from women with no disabilities. Conclusion Women with a variety of types of disabilities experience pregnancy. Greater attention is needed to the reproductive healthcare needs of this population in order to ensure appropriate contraceptive, preconception, and perinatal care.
Background Prior studies have found that women with disabilities who give birth are more likely to have preterm deliveries and low birthweight infants. However, it is not known what proportion of pregnant women with disabilities experience live birth, versus miscarriage or abortion. Objective To compare proportions of live birth, miscarriage, and abortion among women with basic action difficulties, women with complex activity limitations, and women without disabilities in a nationally representative sample. Methods We analyzed pooled Medical Expenditure Panel Survey (MEPS) data from Panels 1–11 (covering years 1996–2007), which included a Pregnancy Detail module assessing outcomes for women who were pregnant during panel participation. We used chi-square tests and multivariable logistic regression to compare disability groups on pregnancy outcomes. Results Among women with a recorded pregnancy outcome, women with disabilities were less likely to have live births (80.8% of women with basic action difficulties and 75.3% of women with complex activity limitations versus 85.0% of women without disabilities), but differences related to disability were not significant when adjusting for covariates. Women with complex activity limitations were significantly more likely to report miscarriages, even when controlling for covariates. Disability was not significantly associated with abortion in the adjusted analysis. Conclusions Our findings add to the growing literature on pregnancy outcomes among women with disabilities, providing important information about outcomes that are not reflected in delivery records. We found few differences between women with and without disabilities, and good likelihood of live birth among women with disabilities experiencing pregnancy.
IntroductionIncreasing numbers of US residents rely on informal caregiving from friends and family members. Caregiving can have substantial health and financial impacts on caregivers. This study addressed whether those impacts include adverse nutritional states. Specifically, we examined household food insecurity, individual hunger, and obesity among caregivers compared with noncaregivers.MethodsWe analyzed 2012 Behavioral Risk Factor Surveillance System data from Oregon. The Caregiving Module was administered to a random subset of 2,872 respondents. Module respondents included 2,278 noncaregivers and 594 caregivers providing care or assistance to a friend or family member with a health problem or disability. We used multivariable logistic regression to assess associations between caregiving status and each of our dependent variables.ResultsCaregivers had significantly greater odds of reporting household food insecurity (odds ratio [OR] = 2.10, P = .003) and personal hunger (OR = 2.89, P = .002), even after controlling for income and other correlates of food insecurity. There were no significant differences in obesity between caregivers and noncaregivers.ConclusionCaregiving is associated with increased risk of food insecurity and hunger in Oregon, suggesting that careful attention to the nutritional profile of households with family caregivers is needed in this population.
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