Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 8;52(1):203-213.
doi: 10.1093/ije/dyac183.

Risk of adverse neonatal outcomes among pregnant women with disabilities

Jessica L Gleason  1 , Jagteshwar Grewal  2 , Zhen Chen  1 , Alison N Cernich  2 , Katherine L Grantz  1
Affiliations

Risk of adverse neonatal outcomes among pregnant women with disabilities

Jessica L Gleason et al. Int J Epidemiol. .

Abstract

Background: To compare risk of neonatal morbidities between women with and without documented disability and to evaluate mediation of these associations by pre-term birth and caesarean delivery.

Methods: Using data from the Consortium on Safe Labor (2002-2008; n = 223 385), we evaluated risk of 22 neonatal outcomes among singleton deliveries using ICD-9 codes to define physical (n = 1733), sensory (n = 250) and intellectual disability (n = 91). Adjusted relative risk (aRR) was estimated for each outcome among each category of disability, and among women with any disability using Poisson regression models with robust variance. Causal mediation methods evaluated pre-term birth and caesarean delivery as mediators.

Results: Compared with no disability, neonates of women with any disability had higher risk of nearly all neonatal outcomes, including pre-term birth (aRR = 1.77; 95% CI 1.62-1.94), small for gestational age (SGA) (aRR = 1.25; CI 1.11-1.41), neonatal intensive care unit (NICU) admission (aRR = 1.70; CI 1.54-1.87), seizures (aRR = 2.81; CI 1.54-5.14), cardiomyopathy (aRR = 4.92; CI 1.15-20.95), respiratory morbidities (aRR ranged from 1.33-2.08) and death (aRR = 2.31; CI 1.38-3.87). Women with disabilities were more likely to have a maternal indication for pre-term delivery, including pre-pregnancy diabetes (aRR = 3.80; CI 2.84-5.08), chronic hypertension (aRR = 1.46; CI 0.95-2.25) and severe pre-eclampsia/eclampsia (aRR = 1.47; CI 1.19-1.81). Increased risk varied but was generally consistent across all disability categories. Most outcomes were partially mediated by pre-term birth, except SGA, and heightened risk remained for NICU admissions, respiratory distress syndrome, anaemia and a composite of any adverse outcome (aRR = 1.21; CI 1.10-1.32).

Conclusion: Neonates of women with disabilities were at higher risk of a broad range of adverse neonatal outcomes, including death. Risks were not fully explained by pre-term birth.

Keywords: Disability; neonatal outcomes; pre-term birth; pregnancy.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Tarasoff LA, Ravindran S, Malik H, Salaeva D, Brown HK.. Maternal disability and risk for pregnancy, delivery, and postpartum complications: a systematic review and meta-analysis. Am J Obstet Gynecol 2020;222:27.e1–e32. - PMC - PubMed
    1. Tarasoff LA, Murtaza F, Carty A, Salaeva D, Hamilton AD, Brown HK.. Health of newborns and infants born to women with disabilities: a meta-analysis. Pediatrics 2020;146:e20201635. - PMC - PubMed
    1. Huennekens K, Oot A, Lantos E, Yee LM, Feinglass J.. Using electronic health record and administrative data to analyze maternal and neonatal delivery complications. Jt Comm J Qual Patient Saf 2020;46:623–30. - PubMed
    1. Mitra M, McKee MM, Akobirshoev I, Ritter GA, Valentine AM.. Pregnancy and neonatal outcomes among deaf or hard of hearing women: results from nationally representative data. Womens Health Issues 2021;31:470–77. - PMC - PubMed
    1. National Institutes of Health. Pregnancy in Women with Disabilities (R01). 2011. https://grants.nih.gov/grants/guide/pa-files/PAR-11-258.html (16 June 2021, date last accessed).

Publication types