Live birth, miscarriage, and abortion among U.S. women with and without disabilities

Horner‐Johnson, Willi; Kulkarni-Rajasekhara, Sheetal; Darney, Blair G.; Dissanayake, Mekhala; Caughey, Aaron B.

doi:10.1016/j.dhjo.2017.02.006

Cited by 24 publications

(19 citation statements)

References 29 publications

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“…Of the 16 included studies, eight were cross‐sectional 13,14,19‐24 and eight were retrospective cohorts 15,17,25‐30 . Studies were conducted in the United States ( n = 13) 13,15,17,19‐22,25‐30 and the United Kingdom (UK) ( n = 3) 14,23,24 and based on nine different data sources including: Massachusetts Pregnancy to Early Life Longitudinal data system (PELL, n = 3) 25‐27 ; California birth certificate and hospital discharge records ( n = 3) 15,17,29 ; Pregnancy Risk Assessment Monitoring System (PRAMS, n = 3) 13,21,22 ; and the UK National Health Service Care Quality Commission Survey ( n = 2) 14,23 . Definitions of physical disabilities varied.…”

Section: Resultsmentioning

confidence: 99%

Pregnancy‐related outcomes among women with physical disabilities: A systematic review

Deierlein

Antoniak

Chan

et al. 2021

Paediatric Perinatal Epid

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Background Disability among women of reproductive age is common; many of these women desire children and do not have impaired fertility. Objectives To examine the epidemiological literature on perinatal health outcomes among women with physical disabilities. Data sources We searched Medline and CINAHL for articles published January 2009–April 2020 following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Study selection and data extraction Eligible studies were observational, quantitative, and reported on physical disabilities in association with prenatal, perinatal, postpartum, and/or infant health outcomes. We included studies that grouped physical and non‐physical disabilities, such as surveys that queried only about general daily life limitations. We excluded case reports, descriptive studies without comparison groups, and studies conducted in low‐ or middle‐income countries. Data extraction was done using predefined data fields. Synthesis All authors were involved in screening activities, data extraction, and/or quality assessment (rating and areas for bias). Results A total of 2650 articles were evaluated, of which sixteen met inclusion criteria (8 cross‐sectional studies and 8 retrospective cohort studies). Assessments of disability status and perinatal outcomes widely varied across studies. Studies were rated as poor (n = 8) or fair quality (n = 8). Findings suggested that women with physical disabilities were at risk of several adverse outcomes, including caesarean delivery, infections, preterm complications, and maternal post‐delivery hospitalisations, while their infants may be at risk of low birthweight and small‐for‐gestational age. Women classified as having complex/severe disabilities were often observed to be at higher risk of adverse outcomes compared to women with less severe disabilities. Conclusions Research assessing how physical, functional, and medical restrictions influence health outcomes among women with physical disabilities, from preconception through postpartum, is limited. Longitudinal studies with comprehensive data collection that accurately identify women with physical disabilities are critical to understanding their reproductive health risks and outcomes.

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Section: Resultsmentioning

confidence: 99%

Pregnancy‐related outcomes among women with physical disabilities: A systematic review

Deierlein

Antoniak

Chan

et al. 2021

Paediatric Perinatal Epid

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“…These results are consistent with and build on a prior finding that women with complex disabilities (which include difficulty with independent living activities) were more likely to have experienced miscarriage than women without disabilities. 20 Because sporadic (as opposed to recurrent) miscarriage is not well-characterized in most women, it is difficult to determine why women with disabilities may be more likely to experience miscarriage. Other research has found that women with disabilities are more likely to have adverse preconception risk factors such as smoking, obesity, diabetes, asthma, frequent mental distress, and lack of emotional support.…”

Section: Discussionmentioning

confidence: 99%

“…One prior study found that women with complex disabilities (those that affected activities of daily living and/or instrumental activities of daily living) were at greater risk of miscarriage than women without disabilities. 20 However, miscarriages among women with different types of disabilities (physical, cognitive, sensory ) have not yet been examined.…”

Section: Introductionmentioning

confidence: 99%

Miscarriage Occurrence and Prevention Efforts by Disability Status and Type in the United States

Dissanayake

Darney

Caughey

et al. 2020

Journal of Women's Health

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Background: Very little is known about early pregnancy loss in women with disabilities. To address this gap, we analyzed nationally representative data on miscarriage and receipt of care focused on miscarriage prevention among women with and without disabilities. Materials and Methods: We used 2011-2015 National Survey of Family Growth data on women with at least one completed pregnancy within the past 5 years. Bivariate and multivariate analyses assessed the association of six disability categories (any, hearing, vision, cognitive, physical, independent living) with miscarriage occurrence and receipt of services intended to prevent miscarriage. Results: Our analytic sample included 3,843 women with 5,776 completed pregnancies within the past 5 years. Overall, 31.63% of women with disabilities and 21.83% of women without disabilities had had a miscarriage within the past 5 years. Compared to women without disabilities, women with any, cognitive, physical, and independent living disability had higher adjusted odds of experiencing miscarriage (any disability aOR = 1.65 [95% CI: 1.21-2.25]). These women also had higher odds of receiving services to prevent miscarriage compared with women without disabilities (any disability aOR = 1.71 [95% CI: 1.20-2.45]). Among women who received services, higher proportions of women with any, vision, physical, or independent living disability received recommendations for bed rest (e.g., 65.007% of women with independent living disability vs. 33.98% of women without disability, p = 0.018). Conclusions: In a representative sample of U.S. women, we found significant differences in the odds of miscarriage and in receipt of care to prevent miscarriage between women with and without disabilities. Further research is needed to understand why women with disabilities are more likely to experience a miscarriage. Such research is important for informing care recommendations.

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“…Except data from small sample size studies, there are only a few population-based representative studies regarding pregnant women with overall disabilities. One study argued no difference in the risk of live births compared to non-disabled women 6 , whereas another study showed the increased risk of preterm births and LBW but not the risk of cesarean deliveries in women with disabilities 7 . Both these studies have strength in that they had a large sample size to prove the relationship, however they had limitations with regards to definition of disability, as they were based on self-reported interviews, which are subjective and unclear.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy and neonatal outcomes of women with disabilities: a nationwide population-based study in South Korea

Shin

Cho

Bak

et al. 2020

Sci Rep

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We investigated (1) pregnancy and neonatal outcomes in women with and without disabilities, (2) time trends in deliveries, and (3) risks of pregnancy and neonatal complications among women with various disability types and severity. this was a nationwide population-based study merging the database of the Korea National Health Insurance claims, National Health Screening Program for Infants and Children, and Disability Registration System to compare perinatal outcomes in women with and without disabilities. Pregnancy and neonatal outcomes were analyzed during 2007 and 2015, as were time trends of deliveries. Multivariate logistic regression was used to evaluate risk of perinatal outcomes among women with various disability types and severities. Women with disabilities showed higher rates of cesarean section (aOR, 1.73; 95% CI, 1.69-1.77), hypertensive disorders (aOR, 1.74; 95% CI, 1.63-1.86), placenta abruption (aOR, 1.27; 95% CI, 1.12-1.45), placenta previa (aOR, 1.14; 95% CI, 1.05-1.24), stillbirths (aOR, 1.30; 95% CI, 1.17-1.45), preterm births (aOR, 1.67; 95% CI, 1.57-1.78), and LBW (aOR, 1.87; 95% CI, 1.78-1.97) than those without disabilities. From 2007 to 2015, although delivery rate in women with disabilities decreased steeply compared with that in women without disabilities, the rate of cesarean section increased in women with disabilities. Women with intellectual disability and those with vision impairment had the highest number of perinatal complications among women with various types of disabilities. Women with disability had more adverse pregnancy and neonatal outcomes than those without disabilities. Specific disability types & severities are more vulnerable to specific perinatal complications. Worldwide, the prevalence of disabilities, defined as experiencing significant functional impairment in everyday life as an adult, is estimated to be 15.6% 1. The global prevalence of disabilities among fertile women varies greatly from 6.4% to 12%, depending on the country and definition of disability 1-3. In South Korea, data from the National Survey on Persons with Disabilities and Korean Statistical Information Service estimated that the prevalence of disabled persons was 2,668,411 (5.39%) nationwide 4 , and the proportion of disabled women among women of childbearing age was 1.39% 5. Emerging literature suggests that women with disabilities who become mothers are at an increased risk for poor maternal health, pregnancy complications, and adverse birth outcomes 6-8. Some studies revealed that women with intellectual disabilities are associated with a higher incidence of cesarean rate 9 , preeclampsia 10 , and preterm births 9. Women with hearing loss were more likely to have preterm labor and low birth weight (LBW) 11 , and visually impaired women had higher rates of cesarean deliveries than women without disabilities 12. Furthermore, women with physical disabilities were confronted with medical and psychosocial risks, as well as barriers to prenatal care and parenting 13,14. However, most of the studies ha...

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Live birth, miscarriage, and abortion among U.S. women with and without disabilities

Cited by 24 publications

References 29 publications

Pregnancy‐related outcomes among women with physical disabilities: A systematic review

Pregnancy‐related outcomes among women with physical disabilities: A systematic review

Miscarriage Occurrence and Prevention Efforts by Disability Status and Type in the United States

Pregnancy and neonatal outcomes of women with disabilities: a nationwide population-based study in South Korea

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