Department of Health and Society and.
Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; and.
Pediatrics. 2020 Dec;146(6). doi: 10.1542/peds.2020-1635. Epub 2020 Nov 17.
Women with disabilities are at elevated risk for pregnancy, delivery, and postpartum complications. However, there has not been a synthesis of literature on the neonatal and infant health outcomes of their offspring.
We examined the association between maternal disability and risk for adverse neonatal and infant health outcomes.
Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, and PsycINFO were searched from database inception to January 2020.
Studies were included if they reported original data on the association between maternal physical, sensory, or intellectual and/or developmental disabilities and neonatal or infant health outcomes; had a referent group of women with no disabilities; were peer-reviewed journal articles or theses; and were written in English.
We used standardized instruments to extract data and assess study quality. DerSimonian and Laird random effects models were used for pooled analyses.
Thirty-one studies, representing 20 distinct cohorts, met our inclusion criteria. Meta-analyses revealed that newborns of women with physical, sensory, and intellectual and/or developmental disabilities were at elevated risk for low birth weight and preterm birth, with smaller numbers of studies revealing elevated risk for other adverse neonatal and infant outcomes.
Most studies had moderate ( = 9) or weak quality ( = 17), with lack of control for confounding a common limitation.
In future work, researchers should explore the roles of tailored preconception and perinatal care, along with family-centered pediatric care particularly in the newborn period, in mitigating adverse outcomes among offspring of women with disabilities.
残疾女性妊娠、分娩和产后并发症的风险增加。然而，目前还没有对其后代新生儿和婴儿健康结果的文献进行综合分析。
我们研究了母体残疾与不良新生儿和婴儿健康结果之间的关联。
从数据库建立到 2020 年 1 月，我们在 Cumulative Index to Nursing and Allied Health Literature、Embase、Medline 和 PsycINFO 中搜索了文献。
如果研究报告了母体身体、感官或智力和/或发育障碍与新生儿或婴儿健康结果之间的关联的原始数据；有一个无残疾女性的参照组；是同行评议的期刊文章或论文；并且是用英语写的，那么这些研究就包括在内。
我们使用标准化工具提取数据并评估研究质量。使用 DerSimonian 和 Laird 随机效应模型进行汇总分析。
31 项研究，代表 20 个不同的队列，符合我们的纳入标准。荟萃分析显示，身体、感官和智力和/或发育障碍女性的新生儿出生体重低和早产的风险增加，而其他一些不良新生儿和婴儿结局的风险增加的研究数量较少。
大多数研究的质量为中等（ = 9）或较差（ = 17），缺乏对混杂因素的控制是一个常见的局限性。
在未来的工作中，研究人员应探索量身定制的孕前和围产期护理，以及以家庭为中心的儿科护理，特别是在新生儿期，在减轻残疾女性后代不良结局方面的作用。
