Murthy Gudlavalleti Venkata S, John Neena, Sagar Jayanthi
South Asia Centre for Disability Inclusive Development and Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, 500033, India.
BMC Womens Health. 2014 Nov 30;14:146. doi: 10.1186/s12905-014-0146-1.
Evidence shows that women with disability have adverse pregnancy outcomes compared to those without a disability. There is a lack of published data on reproductive health of women with disability in India till date. The objective of the South India Disability Evidence (SIDE) Study was to compare reproductive health parameters including pregnancy experience, health access during pregnancy and type of delivery among women with disability compared to women with no disability.
The study was conducted in one district each in two States (Andhra Pradesh and Karnataka) in 2012. A case-control design was used to identify appropriate age and sex-matched controls for women with disability identified through a population-based survey. Trained key informants first listed women with disabilities who were then examined by a medical team to confirm the diagnosis. Trained research investigators administered questionnaire schedules to both groups of women to collect information on reproductive health and outcomes of any pregnancy experienced in the past two years.
A total of 247 women with disability and 324 age-matched controls aged 15-45 years were recruited for the study. 87% of the women with disability had a physical disability. The mean age of women with disability was 29.86 against 29.71 years among women without a disability. A significantly lower proportion of women with disability experienced pregnancy (36.8%) compared to women without a disability (X (2) -16.02 P <0.001). The odds ratio for suffering from diabetes among women with disability compared to women without a disability was 19.3(95% CI: 1.2- 313.9), while it was 9.5 (95% CI: 2.2-40.8) for depression. A higher proportion of women without a disability (7.7%) compared to women with a disability (5.3%) reported a successful pregnancy in the past two years. There were no statistically significant differences between women with and without a disability with regard to utilization of antenatal care and pregnancy outcomes.
The study provides evidence on some reproductive health parameters of women with disability in India for the first time ever. The findings will help in formulating policy and to develop specific interventions to improve pregnancy outcomes for women with disability in India.
有证据表明，残疾女性与非残疾女性相比，妊娠结局较差。迄今为止，印度尚无关于残疾女性生殖健康的已发表数据。南印度残疾证据（SIDE）研究的目的是比较残疾女性与非残疾女性的生殖健康参数，包括妊娠经历、孕期获得的医疗服务以及分娩类型。
2012年在两个邦（安得拉邦和卡纳塔克邦）各选取一个区开展该研究。采用病例对照设计，为通过基于人群的调查确定的残疾女性确定年龄和性别匹配的合适对照。经过培训的关键信息提供者首先列出残疾女性名单，然后由医疗团队对其进行检查以确诊。经过培训的研究调查员向两组女性发放问卷，收集有关生殖健康以及过去两年内任何妊娠结局的信息。
共招募了247名年龄在15至45岁之间的残疾女性和324名年龄匹配的对照。87%的残疾女性存在身体残疾。残疾女性的平均年龄为29.86岁，非残疾女性为29.71岁。与非残疾女性相比，残疾女性经历妊娠的比例显著较低（36.8%）（X（2）=16.02，P<0.001）。残疾女性患糖尿病的比值比为19.3（95%CI：1.2 - 313.9），而患抑郁症的比值比为9.5（95%CI：2.2 - 40.8）。与残疾女性（5.3%）相比，非残疾女性中报告过去两年内成功妊娠的比例更高（7.7%）。在产前护理的利用和妊娠结局方面，残疾女性与非残疾女性之间无统计学显著差异。
该研究首次提供了关于印度残疾女性一些生殖健康参数的证据。这些发现将有助于制定政策，并开发具体干预措施以改善印度残疾女性的妊娠结局。
