4.7 Article

Neonatal Outcomes of Mothers With a Disability

Journal

PEDIATRICS
Volume 150, Issue 3, Pages -

Publisher

AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2021-055318

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Funding

  1. ICES - Ontario Ministry of Health
  2. Ministry of Long-Term Care
  3. Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health [5R01HD092326]

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The study found that newborns of women with disabilities have an elevated risk of complications, especially for women with intellectual or developmental disabilities and those with multiple disabilities. This indicates that women with disabilities may require special attention and care before and during pregnancy.
OBJECTIVES: To assess the risk of neonatal complications among women with a disability. METHODS: This population-based cohort study comprised all hospital singleton livebirths in Ontario, Canada from 2003 to 2018. Newborns of women with a physical (N = 144187), sensory (N = 44988), intellectual or developmental (N = 2207), or >= 2 disabilities (N = 8823) were each compared with 1593354 newborns of women without a disability. Outcomes were preterm birth <37 and <34 weeks, small for gestational age birth weight (SGA), large for gestational age birth weight, neonatal morbidity, and mortality, neonatal abstinence syndrome (NAS), and NICU admission. Relative risks were adjusted for social, health, and health care characteristics. RESULTS: Risks for neonatal complications were elevated among newborns of women with disabilities compared with those without disabilities. Adjusted relative risks were especially high for newborns of women with an intellectual or developmental disability, including preterm birth <37 weeks (1.37, 95% confidence interval 1.19-1.58), SGA (1.37, 1.24-1.59), neonatal morbidity (1.42, 1.27-1.60), NAS (1.53, 1.12-2.08), and NICU admission (1.53, 1.40-1.67). The same was seen for newborns of women with >= 2 disabilities, including preterm birth <37 weeks (1.48, 1.39-1.59), SGA (1.13, 1.07-1.20), neonatal morbidity (1.28, 1.20-1.36), NAS (1.87, 1.57-2.23), and NICU admission (1.35, 1.29-1.42). CONCLUSIONS: There is a mild to moderate elevated risk for complications among newborns of women with disabilities. These women may need adapted and enhanced preconception and prenatal care, and their newborns may require extra support after birth.

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