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美国慢性身体残疾女性的致残状况和当前妊娠情况。

Conditions causing disability and current pregnancy among US women with chronic physical disabilities.

机构信息

*Mongan Institute for Health Policy, Massachusetts General Hospital †Department of Medicine, Harvard Medical School, Boston, MA ‡Center for Nursing Research, Villanova University College of Nursing, Villanova, Pennsylvania §Department of Obstetrics and Gynecology, Massachusetts General Hospital ∥Department of Obstetrics and Gynecology, Harvard Medical School, Boston, MA.

出版信息

Med Care. 2014 Jan;52(1):20-5. doi: 10.1097/MLR.0000000000000015.

Abstract

BACKGROUND

Growing numbers of reproductive-age US women with chronic physical disabilities (CPD) are becoming pregnant. Little is known about the health conditions causing their CPD.

OBJECTIVES

To identify health conditions causing CPD among reproductive-age women and specifically among currently pregnant women.

RESEARCH DESIGN

Cross-sectional, nationally representative National Health Interview Survey data from 2006 to 2011.

SUBJECTS

A total of 6043 civilian, noninstitutionalized women aged 18-49 with CPD.

MEASURES

National Health Interview Survey asks about various movement difficulties and their underlying causes and about current pregnancy. We used responses from 8 movement difficulty and other questions to identify women with mobility difficulties caused by chronic physical health conditions.

RESULTS

Among women with CPD, 2.0% report current pregnancy, with pregnancy rates falling monotonically as CPD severity rises. Regardless of pregnancy, 20.8% report 2 causes for their CPD, and 12.7% report 3+ causes; the most common causes are arthritis, back or neck problems, and other musculoskeletal conditions. Compared with nonpregnant women, currently pregnant women report fewer causal conditions: 15.8% report 2 causes and 8.0% 3+ causes; back or neck problems are reported most frequently, followed by musculoskeletal problems and arthritis. Multivariable logistic regression analyses predicting current pregnancy controlling for age category and individual common causes of CPD found that no cause was significantly associated with higher or lower adjusted odds of pregnancy.

CONCLUSION

Almost one quarter of currently pregnant women with CPD report more than one cause for their disability. Further research will needed to examine how obstetrical needs vary for depending on the cause of a pregnant woman's disability.

摘要

背景

越来越多患有慢性身体残疾(CPD)的美国育龄妇女怀孕。导致这些 CPD 的健康状况知之甚少。

目的

确定导致育龄妇女,特别是目前怀孕妇女 CPD 的健康状况。

研究设计

2006 年至 2011 年全国代表性的横断面国家健康访谈调查数据。

受试者

共有 6043 名 18-49 岁患有 CPD 的平民非住院女性。

措施

国家健康访谈调查询问了各种行动困难及其潜在原因以及当前怀孕情况。我们使用了 8 个关于行动困难和其他问题的回答,来确定因慢性身体健康状况而行动困难的女性。

结果

在患有 CPD 的女性中,有 2.0%报告目前怀孕,随着 CPD 严重程度的增加,怀孕率呈单调下降。无论是否怀孕,20.8%的人报告有 2 个导致 CPD 的原因,12.7%的人报告有 3 个或更多原因;最常见的原因是关节炎、背部或颈部问题和其他肌肉骨骼疾病。与未怀孕的女性相比,目前怀孕的女性报告的病因较少:15.8%报告有 2 个原因,8.0%报告有 3 个或更多原因;背部或颈部问题报告最多,其次是肌肉骨骼问题和关节炎。多变量逻辑回归分析预测控制年龄类别和常见 CPD 病因的当前妊娠,发现没有一个病因与调整后的妊娠几率更高或更低显著相关。

结论

近四分之一患有 CPD 的目前怀孕的女性报告有不止一个导致残疾的原因。需要进一步研究,以检查孕妇残疾的病因如何影响产科需求。

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