National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
University of Arizona Medical Center-University Campus, Tucson, Arizona, USA.
J Womens Health (Larchmt). 2023 Jul;32(7):740-746. doi: 10.1089/jwh.2022.0395. Epub 2023 May 12.
Women with disabilities are less likely to receive reproductive health counseling than women without disabilities. Yet, little is known about reproductive health counseling and concerns among women with congenital heart defects (CHD) and disabilities. We used population-based survey data from 778 women aged 19 to 38 years with CHD to examine contraceptive and pregnancy counseling and pregnancy concerns and experiences by disability status, based on six validated questions on vision, hearing, mobility, cognition, self-care, and living independently. Multivariable Poisson regression was used to examine adjusted prevalence ratios between disability status and each outcome, adjusted for CHD severity, age, race/ethnicity, place of birth (Arkansas, Arizona, Georgia), and insurance type. Women with disabilities ( = 323) were 1.4 and 2.3 times more likely than women without disabilities ( = 455) to receive clinician counseling on safe contraceptive methods and avoiding pregnancy because of their CHD. Women with CHD and disabilities, compared to those without disabilities, were more likely to be concerned about their ability to have children (aPR = 1.2) and to have delayed or avoided pregnancy (aPR = 2.2); they were less likely to have ever been pregnant (aPR = 0.7). Associations differed slightly across specific disability types. All associations remained after excluding 71 women with chromosomal anomalies. Among women with CHD, reproductive counseling, concerns, and experiences differ by disability status.
残疾女性接受生殖健康咨询的可能性低于非残疾女性。然而，对于患有先天性心脏病（CHD）和残疾的女性的生殖健康咨询和关注点知之甚少。我们使用了基于人群的调查数据，对 778 名年龄在 19 至 38 岁的患有 CHD 的女性进行了研究，这些女性基于视力、听力、行动能力、认知能力、自理能力和独立生活能力等六个经过验证的问题，探讨了避孕和妊娠咨询以及妊娠关注和经历与残疾状况的关系。采用多变量泊松回归分析，根据残疾状况和每种结局，调整了 CHD 严重程度、年龄、种族/民族、出生地（阿肯色州、亚利桑那州、佐治亚州）和保险类型的比值比。与非残疾女性（ = 455）相比，有残疾的女性（ = 323）更有可能接受关于安全避孕方法和避免因 CHD 而怀孕的临床医生咨询，其比值比为 1.4 和 2.3。与没有残疾的女性相比，患有 CHD 和残疾的女性更有可能担心自己生育能力（aPR = 1.2）和延迟或避免怀孕（aPR = 2.2）；她们怀孕的可能性较小（aPR = 0.7）。特定残疾类型的关联略有不同。在排除了 71 名患有染色体异常的女性后，所有关联仍然存在。在患有 CHD 的女性中，残疾状况会影响生殖咨询、关注和经历。
