Ward Caitlin A, Goss Katherine D, Angles John S, Turk Margaret A
College of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, New York, USA.
Womens Health Rep (New Rochelle). 2022 Apr 8;3(1):420-429. doi: 10.1089/whr.2021.0015. eCollection 2022.
A lack of consensus in the literature examining reproductive health experiences of women with disability prevails, in part, due to various operational definitions of disability.
Results from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) were utilized to assess reproductive health, disability, and demographic variables among women aged 20-44. Disability was assessed using the six functional limitation subgroups. Analyses included modified Poisson regression and negative binomial regression.
One hundred eighty-two (14%) women reported having any functional limitation. Women with at least one functional limitation (WWFL) were significantly more likely than women without a functional limitation (WWOFL) to have had a hysterectomy and had more cesarean deliveries. WWFL did not differ significantly from WWOFL in key pregnancy outcomes (ever been pregnant, number of pregnancies, or number of unsuccessful pregnancies). A high degree of overlap between mobility and self-care (66.1%), cognitive and independent living (61%), and mobility and independent living (37.4%) limitations was found.
This work summarizes key reproductive health variables among US women of reproductive age and contextualizes disability experiences through subgroup and overlap analysis. Subgroup analysis results demonstrate the need for detailed operational definitions of disability to accurately capture experiences of women with different limitations, and overlap analysis indicates the interconnectedness of limitations among this group. Findings call for future exploration of reproductive health-related similarities and differences between WWD and women without disability, and employment of detailed operational definitions of disability.
关于残疾女性生殖健康经历的文献缺乏共识，部分原因是残疾的各种操作定义不同。
利用2015 - 2016年国家健康与营养检查调查（NHANES）的结果，评估20 - 44岁女性的生殖健康、残疾和人口统计学变量。使用六个功能受限亚组评估残疾情况。分析包括修正泊松回归和负二项回归。
182名（14%）女性报告有任何功能受限。至少有一项功能受限的女性（WWFL）比无功能受限的女性（WWOFL）进行子宫切除术的可能性显著更高，剖宫产次数也更多。WWFL与WWOFL在关键妊娠结局（曾怀孕、怀孕次数或未成功怀孕次数）方面无显著差异。发现行动能力和自我护理受限（66.1%）、认知和独立生活受限（61%）以及行动能力和独立生活受限（37.4%）之间存在高度重叠。
这项工作总结了美国育龄女性的关键生殖健康变量，并通过亚组和重叠分析将残疾经历置于背景中。亚组分析结果表明，需要对残疾进行详细的操作定义，以准确捕捉不同受限女性的经历，而重叠分析表明该群体中各种受限之间存在相互联系。研究结果呼吁未来探索残疾女性与非残疾女性在生殖健康方面的异同，并采用详细的残疾操作定义。
