智力或其他发育障碍女性不良分娩结局的相关因素
Factors Associated with Adverse Birth Outcomes in Women with an Intellectual or Other Developmental Disability.
作者信息
Jones Kyle Bradford, Taylor Isabel K, Schwab Tyson, King Camille, Okoye Godwin, Kim Jaewhan
机构信息
Department of Family and Preventive Medicine, University of Utah Spencer Fox Eccles School of Medicine, 240 Morris Ave. #400, South Salt Lake City, UT 84115, USA.
Department of Pediatrics, University of Utah Spencer Fox Eccles School of Medicine, 50 Medical Drive, Salt Lake City, UT 84132, USA.
出版信息
Healthcare (Basel). 2025 Mar 31;13(7):780. doi: 10.3390/healthcare13070780.
Women with intellectual or developmental disabilities (IDDs) experience poorer prenatal care and worse perinatal health and birth outcomes than the general population. The purpose of this study is to describe the maternal characteristics and to identify factors associated with the increased risk of adverse birth outcomes among women with an IDD. Electronic medical records and the Utah Population Database were used to identify demographic and medical characteristics of pregnant individuals between 14 and 45 years old with an IDD and the related birth outcomes. Random-effects logistic regression was used to identify factors that were associated with adverse birth outcomes. A total of 5147 births by 2250 mothers with an IDD (average births per mother = 2.33) were identified. Multigestational pregnancy (twins or triplets) (OR = 32.85, < 0.01), fewer prenatal care visits (OR = 3.01, <0.01), gestational hypertension (OR = 2.74, < 0.01), and the presence of a mental illness (OR = 1.28, = 0.01) had an increased risk for preterm delivery. Associated low birth weight factors included multigestational pregnancy (OR = 22.82, < 0.01), gestational hypertension (OR = 3.23, < 0.01), maternal smoking status (OR = 1.54, < 0.01), fewer prenatal visits (OR = 2.91, < 0.01), and maternal mental health disorder (OR = 1.66, < 0.01). Cesarean deliveries were associated with gestational hypertension (OR = 2.33, < 0.01), Medicaid coverage (OR = 1.76, < 0.01), and gestational diabetes (OR = 1.42, < 0.01). Neonatal intensive care unit (NICU) admission was associated with increasing maternal age, multigestational pregnancy, the number of prenatal care visits, hypertension, and maternal mental disorders. These results suggest that sociodemographic factors and health problems put women with an IDD at a higher risk of adverse pregnancy and infant outcomes. Appropriate clinical care and social supports should be utilized to optimize the health and outcomes of this population.
与普通人群相比，患有智力或发育障碍（IDD）的女性接受的产前护理较差，围产期健康状况和分娩结局也更糟。本研究的目的是描述这些孕产妇的特征，并确定与IDD女性不良分娩结局风险增加相关的因素。利用电子病历和犹他州人口数据库来确定14至45岁患有IDD的孕妇的人口统计学和医学特征以及相关的分娩结局。采用随机效应逻辑回归来确定与不良分娩结局相关的因素。共识别出2250名患有IDD的母亲的5147次分娩（每位母亲平均分娩2.33次）。多胎妊娠（双胞胎或三胞胎）（OR = 32.85，<0.01）、产前检查次数较少（OR = 3.01，<0.01）、妊娠期高血压（OR = 2.74，<0.01）和患有精神疾病（OR = 1.28，= 0.01）会增加早产风险。与低出生体重相关的因素包括多胎妊娠（OR = 22.82，<0.01）、妊娠期高血压（OR = 3.23，<0.01）、母亲吸烟状况（OR = 1.54，<0.01）、产前检查次数较少（OR = 2.91，<0.01）和母亲心理健康障碍（OR = 1.66，<0.01）。剖宫产与妊娠期高血压（OR = 2.33，<0.01）、医疗补助覆盖（OR = 1.76，<0.01）和妊娠期糖尿病（OR = 1.42，<0.01）有关。新生儿重症监护病房（NICU）收治与母亲年龄增加、多胎妊娠、产前检查次数、高血压和母亲精神障碍有关。这些结果表明，社会人口学因素和健康问题使患有IDD的女性面临更高的不良妊娠和婴儿结局风险。应利用适当的临床护理和社会支持来优化这一人群的健康状况和结局。
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