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Comparative Study
. 2020 Oct;13(4):100934.
doi: 10.1016/j.dhjo.2020.100934. Epub 2020 Apr 22.

Prolonged postpartum length of hospital stay among women with disabilities

Willi Horner-Johnson  1 , Blair G Darney  2 , Frances M Biel  2 , Aaron B Caughey  2
Affiliations
Comparative Study

Prolonged postpartum length of hospital stay among women with disabilities

Willi Horner-Johnson et al. Disabil Health J. 2020 Oct.

Abstract

Background: Prior studies have found higher proportions of cesarean deliveries and longer postpartum hospital stays among women with disabilities compared to women without disabilities. However, no research has assessed how length of stay may differ for women with different types of disability while also considering mode of delivery.

Objective: To examine the association of disability status and disability type with length of stay, taking into account disability-related differences in mode of delivery.

Methods: We conducted a retrospective cohort study using linked maternal and infant hospital discharge and vital records data for all births in California between 2000 and 2012 (n = 6,745,201). We used multivariable regression analyses to assess association of disability status and type with prolonged length of stay (>2 days for vaginal delivery or >4 days for cesarean) while controlling for covariates.

Results: Women with disabilities had significantly elevated adjusted odds of prolonged length of stay compared to women without disabilities (aOR = 1.40, 95% CI = 1.32-1.49). Adjusted odds were highest for women with vision disabilities (aOR = 1.67, 95% CI = 1.46-1.90), followed by women with IDD (aOR = 1.53, 95% CI = 1.30-1.80), and women with physical disabilities (aOR = 1.41, 95% CI = 1.32-1.50). Women with hearing disability had the lowest adjusted odds of prolonged length of stay (aOR = 1.17, 95% CI = 1.03-1.33).

Conclusions: Prolonged length of stay did not appear to be due solely to the higher proportion of cesarean deliveries in this population. Further research is needed to better understand the reasons for prolonged length of stay among women with disabilities and develop strategies to assist women with disabilities in preparing for and recovering from childbirth.

Keywords: Length of stay; Persons with disabilities; Postpartum period; Women’s health.

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Conflict of interest statement

Conflict of Interest

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Unadjusted prevalence of prolonged length of stay by disability status and typea aAll disability groups significantly differed from the no disability group at p<.001. bIDD: Intellectual and developmental disabilities cProlonged length of stay: >2 days for vaginal delivery or >4 days for cesarean delivery
Figure 2.
Figure 2.
Estimated adjusteda prevalence of prolonged length of stay by disability status and type aAdjusted for age, race/ethnicity, education, insurance, prenatal care initiation, gestational diabetes, gestational hypertension/preeclampsia, preterm birth, chronic diabetes, chronic hypertension, mental health diagnosis, and birth year bIDD: Intellectual and developmental disabilities cProlonged length of stay: >2 days for vaginal delivery or >4 days for cesarean delivery *Statistically significantly different from no disability group at p<.05.
See this image and copyright information in PMC

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