Interdisciplinary Centre for Health & Society, University of Toronto Scarborough, Scarborough, Canada.
Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada.
J Womens Health (Larchmt). 2020 Dec;29(12):1564-1575. doi: 10.1089/jwh.2019.8273. Epub 2020 Jul 14.
: There is growing recognition that preconception health, defined as the health of all reproductive-age individuals, impacts reproductive and perinatal outcomes. Although women with disabilities are becoming pregnant at increasing rates, little is known about their preconception health. Our objective was to describe the preconception health characteristics of women with physical, sensory, and intellectual/developmental disabilities and compare these characteristics with women without disabilities. : We conducted a population-based cross-sectional study of 15- to 44-year-old women with physical ( = 253,184), sensory ( = 93,170), intellectual/developmental ( = 8,986), and multiple disabilities ( = 29,868), and women without these disabilities ( = 2,307,822) using Ontario health administrative data (2017-2018). We described preconception health variables related to social determinants of health, physical health status, psychosocial well-being, history of assault, medication use, and continuity of primary care and compared women with and without disabilities in crude and age-standardized analyses, with standardized differences >0.10 indicating clinically meaningful results. : Women with physical, sensory, intellectual/developmental, and multiple disabilities had poorer preconception health than women without disabilities. Disparities were pronounced for physical health status, psychosocial well-being, use of potentially teratogenic medications, and history of assault. Of all groups, women with intellectual/developmental disabilities had the greatest disparities. : Further research is needed to identify contributors to poor preconception health among women with disabilities and to develop tailored preconception health interventions to meet their unique needs and experiences.
越来越多的人认识到,孕前健康(定义为所有育龄个体的健康)会影响生殖和围产期结局。尽管残疾女性的怀孕率不断上升,但她们的孕前健康状况却知之甚少。我们的目的是描述身体、感官和智力/发育残疾女性的孕前健康特征,并将这些特征与无残疾女性进行比较。
我们使用安大略省健康管理数据(2017-2018 年)对 15 至 44 岁的身体残疾( = 253,184 人)、感官残疾( = 93,170 人)、智力/发育残疾( = 8,986 人)和多重残疾( = 29,868 人)女性以及无这些残疾的女性( = 2,307,822 人)进行了一项基于人群的横断面研究。我们描述了与健康决定因素、身体健康状况、心理健康、性侵犯史、药物使用以及初级保健连续性相关的孕前健康变量,并在未经调整和年龄标准化分析中比较了有和无残疾的女性,标准化差异 >0.10 表明存在临床意义的结果。
身体、感官、智力/发育和多重残疾的女性的孕前健康状况比无残疾的女性差。身体健康状况、心理健康、潜在致畸药物使用和性侵犯史方面的差异更为明显。在所有群体中,智力/发育残疾女性的差异最大。
需要进一步研究以确定导致残疾女性孕前健康状况不佳的因素,并制定针对她们独特需求和经历的定制化孕前健康干预措施。