Childbearing among women with disabilities has increased, although few studies have examined pregnancy course and birth outcomes among affected women, with most reports based on small, single institution case series. Women with physical or intellectual disabilities may have characteristics placing them or their infants at increased risk of adverse outcomes, so it is important to improve our understanding of how they may achieve healthy outcomes and offspring. This is a resubmission proposal for an exploratory project using existing population-based data to examine pregnancy outcomes in women with physical and intellectual disabilities. Epidemiologic data analyses will use existing linked birth-hospital discharge records to identify women with physical, intellectual, or other disabilities wit deliveries in Washington State 1987-2011. Nearly 3000 deliveries to women with disabilities will be identified based on ICD codes in the hospital discharge record. A comparison group of women without disabilities will be randomly selected in a 10:1 ratio, frequency matched on delivery year. The number and proportion of deliveries to women with disabilities overall, and by type of disability will be described. The extent to which women with and without disabilities diffe with respect to personal and behavioral characteristics (age at delivery, education, pre-pregnancy weight, smoker status, etc.), and factors related to care access and social support (prenatal care, health insurance, marital status, etc.) will be measured. The occurrence of pregnancy conditions (e.g., preeclampsia, gestational diabetes) and outcomes (preterm delivery, c-section, infant low birth weight, small size for gestational age, malformation, need fo rehospitalization, etc.) among subgroups of women with, and without different disabilities will be compared. We will identify and meet with providers and support groups in the region ("community partners") to gain a fuller understanding of the most relevant questions and variables to explore, and to discuss the results, with a goal of developing future targeted assessments of outcomes, issues, or subgroups.
Childbearing among women with disabilities has increased. In the few studies that have examined outcomes among these women, complications such as preeclampsia, and adverse outcomes such as infant low birth weight, preterm delivery, malformations, and maternal rehospitalization reportedly occur more frequently than among women without disabilities. Understanding the factors that impact access to care and outcome in women with different types of disabilities will help improve pregnancy and infant outcomes.