Horner-Johnson Willi, Darney Blair G, Kulkarni-Rajasekhara Sheetal, Quigley Brian, Caughey Aaron B
Institute on Development and Disability, Oregon Health and Science University, Portland, OR.
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR; National Institute of Public Health, Center for Health Systems Research, Cuernavaca, Mexico.
Am J Obstet Gynecol. 2016 Apr;214(4):529.e1-529.e9. doi: 10.1016/j.ajog.2015.10.929. Epub 2015 Nov 4.
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.
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 with women without disabilities, in a nationally representative sample.
We conducted cross-sectional analyses of 2008-2012 Medical Expenditure Panel Survey annualized data to estimate the proportion of women aged 18-44 years with and without disabilities who reported a pregnancy during 1 year of participation on the survey panel. We used a multivariable logistic regression to test the association of pregnancy with presence, type, and complexity of disability, controlling for other factors associated with pregnancy.
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 (adjusted odds ratio, 0.69, 95% confidence interval, 0.52-0.93), but women whose disabilities affected only basic actions (seeing, hearing, movement, cognition) did not differ significantly from women with no disabilities.
Women with a variety of types of disabilities experience pregnancy. Greater attention is needed to the reproductive health care needs of this population to ensure appropriate contraceptive, preconception, and perinatal care.
约12%的育龄妇女患有某种类型的残疾。对于残疾女性的性与生殖健康问题,包括残疾女性怀孕的比例,我们知之甚少。怀孕数据对于了解残疾女性孕前和孕期护理需求至关重要。
本研究旨在描述在全国代表性样本中,各类残疾及残疾复杂程度不同的女性与非残疾女性相比的怀孕发生率。
我们对2008 - 2012年医疗支出小组调查的年度数据进行横断面分析,以估计18 - 44岁参与调查小组1年期间报告怀孕的残疾和非残疾女性的比例。我们使用多变量逻辑回归来检验怀孕与残疾的存在、类型和复杂程度之间的关联,并控制其他与怀孕相关的因素。
残疾和非残疾女性报告怀孕的比例相似(分别为10.8%和12.3%,95%置信区间重叠)。残疾最复杂(影响自我护理和工作等活动)的女性怀孕的可能性较小(调整后的优势比为0.69,95%置信区间为0.52 - 0.93),但仅影响基本行动(视力、听力、运动、认知)的残疾女性与非残疾女性没有显著差异。
各类残疾女性都会怀孕。需要更加关注这一人群的生殖健康护理需求,以确保提供适当的避孕、孕前和围产期护理。