Abstract
Background: Research on perinatal outcomes among women with intellectual and developmental disabilities (IDD) is emerging. However, little is known about birth outcomes among women with IDD by type of disability. Therefore,we examined birth outcomes among women with developmental disabilities (DD) and intellectual disabilities (ID) compared to women with cerebral palsy (CP).
Methods: We analyzed 2004–2014 Healthcare Cost and Utilization Project National Inpatient Sample data. Using multivariate logistic regression analysis, we compared birth outcomes in women with DD and ID to women with CP.
Results:We identified 742 , 2,031, and 1,775 delivery-associated hospitalizations among women with DD, ID, and CP respectively. Women with DD and with ID were less likely to have cesarean delivery in contrast to women with CP (OR=0.55,95% CI:0.46-0.66,P<0.01 and OR=0.72, 0.62-0.83,P<0.01 respectively). However, compared to women with CP, the risk of adverse birth outcomes were significantly higher for women with DD and with ID, including fetal distress (OR=1.36,95%CI:1.08-1.72,P<0.01 and OR=1.59,95%CI:1.32-1.91,P<0.01 respectively), fetal abnormalities (OR=7.06,95% CI: 4.31 - 11.55,P<0.01 and OR=2.64,95%CI:1.63-4.28,P<0.01 respectively), stillbirth (OR=5.45,95%CI:2.86-10.37,P<0.01 and OR=2.33,95%CI:1.17-4.61,P<0.01 respectively), and their infant were more likely to be small for gestation age (OR=1.74,95%CI:1.17-2.58,P<0.01 and OR=1,85,95%CI:1.34-2.56,P<0.01 respectively), even after adjusting for age, race, ethnicity, insurance type, neighborhood income, number of comorbidities, hospital bed size, and region. No differences were observed for preterm birth.
Conclusions: Our findings indicate significant disparities in birth outcomes among women with ID, DD, and CP, and underscore the need for more research to develop better strategies for perinatal care delivery to women with differing disabilities