Kalpakjian Claire Z, Mulenga Lukonde, McIntosh Shannen M, Kreschmer Jodi M, Parten Rebecca, Haapala Heidi, Langen Elizabeth S, Rosenblum Sara A S, Pazhyanur Svati, Carlson Susan, Berri Maryam, Ernst Susan D
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, USA.
Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, USA.
Womens Health (Lond). 2025 Jan-Dec;21:17455057251338424. doi: 10.1177/17455057251338424. Epub 2025 May 26.
Women with disabilities have a similar desire for pregnancy as their non-disabled peers but experience more ambivalence and doubt about their intention to have a child. While many have healthy pregnancies, they face higher risks and trade-offs in health, function, and independence.
To review the literature on pregnancy in women with physical disabilities to guide interventions and clinical care guidelines.
Abstracts were reviewed if they were original research on pregnancy involving adult women with physical disabilities. Both qualitative and quantitative studies were included, with no restrictions on language or publication year.
PubMed, Scopus, and CINAHL Complete and reference lists of eligible articles.
Abstracts were eligible for full-text review if they were (1) original research, (2) in humans, (3) about pregnancy, and (4) involved adult women with physical disabilities. Data were extracted by independent reviewers using Covidence software and assessed with a customized critical appraisal guide.
Five major topics characterized 171 reviewed articles: (1) rates of pregnancy, fertility, and termination or loss; (2) pregnancy complications and infant outcomes; (3) effects of pregnancy on physical function disease activity; (4) maternal care; and (5) social and interpersonal dimensions of pregnancy. Most studies were conducted in the Americas and Europe, and high-income countries used a quantitative design and were assessed to have a moderate risk of bias.
This review highlights the need for future research to (1) build a stronger evidence base for tailored maternal care, (2) examine disability discrimination's impact on pregnancy outcomes, (3) develop interventions to reduce disability-related inequities, and (4) improve disability competence among maternal care providers.
残疾女性与非残疾同龄人一样有怀孕的意愿，但对生育意愿存在更多的矛盾心理和疑虑。虽然许多人孕期健康，但她们在健康、功能和独立性方面面临更高的风险和权衡。
回顾有关身体残疾女性怀孕的文献，以指导干预措施和临床护理指南。
如果摘要为关于成年身体残疾女性怀孕的原创研究，则予以审查。纳入定性和定量研究，对语言或出版年份无限制。
PubMed、Scopus和CINAHL Complete以及符合条件文章的参考文献列表。
如果摘要符合以下条件，则有资格进行全文审查：（1）原创研究；（2）以人为研究对象；（3）关于怀孕；（4）涉及成年身体残疾女性。数据由独立评审员使用Covidence软件提取，并根据定制的批判性评价指南进行评估。
171篇被审查文章呈现出五个主要主题：（1）怀孕、生育以及终止妊娠或流产率；（2）妊娠并发症和婴儿结局；（3）怀孕对身体功能疾病活动的影响；（4）孕产妇护理；（5）怀孕的社会和人际层面。大多数研究在美洲和欧洲进行，高收入国家采用定量设计，且被评估存在中度偏倚风险。
本综述强调未来研究需要：（1）为量身定制的孕产妇护理建立更坚实的证据基础；（2）研究残疾歧视对妊娠结局的影响；（3）制定干预措施以减少与残疾相关的不平等现象；（4）提高孕产妇护理提供者的残疾问题处理能力。
