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残疾女性的孕产妇特征、妊娠并发症及不良分娩结局

Maternal Characteristics, Pregnancy Complications, and Adverse Birth Outcomes Among Women With Disabilities.

作者信息

Mitra Monika, Clements Karen M, Zhang Jianying, Iezzoni Lisa I, Smeltzer Suzanne C, Long-Bellil Linda M

机构信息

*Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury †The Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA ‡Center for Nursing Research, Villanova University College of Nursing, Villanova, PA.

出版信息

Med Care. 2015 Dec;53(12):1027-32. doi: 10.1097/MLR.0000000000000427.

Abstract

OBJECTIVES

The objective of this study is to describe the maternal characteristics, pregnancy complications, and birth outcomes among a representative sample of Rhode Island women with disabilities who recently gave birth.

METHODS

Data from the 2002-2011 Rhode Island Pregnancy Risk Assessment Monitoring System survey were analyzed.

RESULTS

Approximately 7% of women in Rhode Island reported a disability. Women with disabilities reported significant disparities in their health care utilization, health behaviors, and health status before and during pregnancy and during the postpartum period. Compared with nondisabled women, they were significantly more likely to report stressful life events and medical complications during their most recent pregnancy, were less likely to receive prenatal care in the first trimester, and more likely to have preterm births (13.4%; 95% CI, 11.6-15.6 compared with 8.9%; 95% CI, 8.5-9.3 for women without disabilities) and low-birth-weight babies (10.3%; 95% CI, 9.4-11.2 compared with 6.8%; 95% CI, 6.8-6.9). There was no difference in the rates of cesarean section between women with and without disabilities.

CONCLUSIONS

These findings support the need for clinicians providing care to pregnant women with disabilities to be aware of the increased risk for medical problems during pregnancy and factors that increase the risk for poor infant outcomes.

摘要

目的

本研究的目的是描述罗德岛近期分娩的残疾妇女代表性样本中的孕产妇特征、妊娠并发症和分娩结局。

方法

分析了2002 - 2011年罗德岛妊娠风险评估监测系统调查的数据。

结果

罗德岛约7%的妇女报告有残疾。残疾妇女在孕期前后及产后的医疗保健利用、健康行为和健康状况方面存在显著差异。与非残疾妇女相比,她们在最近一次妊娠期间更有可能报告有压力的生活事件和医疗并发症,在孕早期接受产前护理的可能性较小,早产(13.4%;95%置信区间为11.6 - 15.6,而非残疾妇女为8.9%;95%置信区间为8.5 - 9.3)和低体重儿(10.3%;95%置信区间为9.4 - 11.2,而非残疾妇女为6.8%;95%置信区间为6.8 - 6.9)的可能性更大。残疾妇女和非残疾妇女的剖宫产率没有差异。

结论

这些发现支持为残疾孕妇提供护理的临床医生需要意识到孕期医疗问题风险增加以及导致婴儿不良结局风险增加的因素。

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