Newby-Kew Abigail, Snowden Jonathan M, Akobirshoev Ilhom, Valentine Anne, Mitra Monika, Horner-Johnson Willi
Oregon Health & Science University and Portland State University School of Public Health; Institute on Development and Disability, School of Medicine, Oregon Health & Science University, Portland, Oregon.
Oregon Health & Science University and Portland State University School of Public Health; Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon.
Am J Prev Med. 2024 Apr;66(4):655-663. doi: 10.1016/j.amepre.2023.11.022. Epub 2023 Nov 24.
Prior studies have shown that, compared to non-disabled women, women with disabilities have a higher burden of preconception mental and physical health risks that are associated with adverse pregnancy outcomes. This cross-sectional study assesses how the extent of disability relates to pre-pregnancy health risks.
This study used 2019-2020 PRAMS data from 22 sites that included the Washington Group Short Set of Questions on Disability (n=37,006). In 2023, associations between extent of disability (none [reference group], some difficulty, or a lot of difficulty) and preconception health risks were examined using multivariable Poisson regression with robust standard errors to calculate adjusted prevalence ratios (aPRs) and 95% CIs while controlling for sociodemographic characteristics. Preconception health risks included smoking, heavy drinking, high blood pressure, diabetes, no multivitamin use, and experiencing physical abuse, depression, or obesity. Individual risks were analyzed, as well as the total number of risks experienced.
Of respondents, 33.6% had some difficulty and 6.3% had a lot of difficulty. The likelihood of experiencing preconception health risks increased with extent of disability. Compared to respondents with no difficulty, those with some or a lot of difficulty had a higher prevalence of experiencing 1-2 health risks (aPR=1.13, 95% CI 1.09, 1.18; aPR=1.20; 95% CI 1.53, 2.25) and 3+ health risks (aPR=1.86, 95% CI 1.53, 2.25; aPR=2.42, 95% CI 1.98, 2.97), respectively.
Disabled women, especially those with more difficulty, are vulnerable to preconception health risks that could potentially be mitigated before conception. These findings highlight the need for enhanced efforts to support preconception health of disabled women.
先前的研究表明，与非残疾女性相比，残疾女性孕前心理和身体健康风险负担更高，这些风险与不良妊娠结局相关。这项横断面研究评估了残疾程度与孕前健康风险之间的关系。
本研究使用了来自22个地点的2019 - 2020年妊娠风险评估监测系统（PRAMS）数据，其中包括华盛顿小组残疾问题简短问卷（n = 37,006）。2023年，在控制社会人口学特征的同时，使用稳健标准误的多变量泊松回归分析残疾程度（无[参照组]、有一些困难或有很大困难）与孕前健康风险之间的关联，以计算调整患病率比（aPRs）和95%置信区间（CIs）。孕前健康风险包括吸烟、大量饮酒、高血压、糖尿病、未服用多种维生素以及遭受身体虐待、抑郁或肥胖。分析了个体风险以及经历的风险总数。
在受访者中，33.6%有一些困难，6.3%有很大困难。孕前健康风险的发生可能性随着残疾程度的增加而增加。与没有困难的受访者相比，有一些困难或有很大困难的受访者经历1 - 2种健康风险的患病率更高（aPR = 1.13，95% CI 1.09，1.18；aPR = 1.20；95% CI 1.53，2.25），经历3种及以上健康风险的患病率更高（aPR = 1.86，95% CI 1.53，2.25；aPR = 2.42，95% CI 1.98，2.97）。
残疾女性，尤其是那些困难更大的女性，易患孕前健康风险，这些风险在受孕前可能得到缓解。这些发现凸显了加大力度支持残疾女性孕前健康的必要性。
