Akobirshoev Ilhom, Parish Susan L, Mitra Monika, Rosenthal Eliana
Lurie Institute for Disability Policy, Brandeis University, Waltham, MA, USA.
Lurie Institute for Disability Policy, Brandeis University, Waltham, MA, USA.
Disabil Health J. 2017 Jul;10(3):406-412. doi: 10.1016/j.dhjo.2017.02.010. Epub 2017 Apr 6.
Women with intellectual and developmental disabilities (IDD) are bearing children at increasing rates. However, there is very little research about pregnancy experiences and birth outcomes among women with IDD. No studies to date have examined birth outcomes with a US population-based sample.
The main objective was to estimate the national occurrence of deliveries in women with IDD and to compare their birth outcomes to women without IDD.
We examined the 2007-2011 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project to compare birth outcomes in women with and without IDD. Birth outcomes included preterm birth, low birth weight, and stillbirth. Multivariable regression analyses compared birth outcomes between women with and without IDD controlling for race/ethnicity, maternal age, household income, health insurance status and type, comorbidity, region and hospital location, teaching status, ownership, and year.
Of an estimated 20.6 million deliveries identified through the HCUP 2007-2011 data 10,275 occurred in women with IDD. In adjusted regression analyses, women with IDD compared to those without IDD were significantly more likely to have preterm birth (OR = 1.46; 95%CI: 1.26-1.69, p < 0.001), low birth weight (OR = 1.61, 95%CI: 1.27-2.05, p < 0.001), and stillbirth (OR = 2.40, 95% CI: 1.70-3.40, p < 0.001).
This study provides a first examination of the birth outcomes among women with IDD in the United States using a largest population-based sample. There are significant differences in birth outcomes between women with and without IDD. Understanding the causes of these differences and addressing these causes are critical to improving pregnancy outcomes among women with IDD.
智力和发育障碍(IDD)女性生育孩子的比例在不断上升。然而,关于IDD女性的怀孕经历和分娩结局的研究非常少。迄今为止,尚无研究以美国基于人群的样本对分娩结局进行调查。
主要目的是估计美国IDD女性的分娩发生率,并将她们的分娩结局与非IDD女性进行比较。
我们研究了2007 - 2011年医疗成本和利用项目的全国住院患者样本,以比较IDD女性和非IDD女性的分娩结局。分娩结局包括早产、低出生体重和死产。多变量回归分析在控制种族/民族、产妇年龄、家庭收入、健康保险状况和类型、合并症、地区和医院位置、教学状况、所有权以及年份的情况下,比较了IDD女性和非IDD女性的分娩结局。
通过2007 - 2011年医疗成本和利用项目(HCUP)数据确定的估计2060万例分娩中,有10275例发生在IDD女性中。在调整后的回归分析中,与非IDD女性相比,IDD女性更有可能出现早产(比值比[OR]=1.46;95%置信区间[CI]:1.26 - 1.69,p<0.001)、低出生体重(OR = 1.61,95%CI:1.27 - 2.05,p<0.001)和死产(OR = 2.40,95%CI:1.70 - 3.40,p<0.001)。
本研究首次使用最大的基于人群的样本,对美国IDD女性的分娩结局进行了调查。IDD女性和非IDD女性的分娩结局存在显著差异。了解这些差异的原因并解决这些原因对于改善IDD女性的妊娠结局至关重要。