Pregnancy Complications and Outcomes among Women with Disabilities

Background: The current literature on the health and health care needs of women with disabilities around the time of pregnancy is limited. Efforts to improve their perinatal care would benefit from more definitive documentation of the potential risks and outcomes of pregnancy. Objectives: The purpose of this study is to utilize population-based data to examine the pregnancy-related complications, maternal stressors and outcomes among women with disabilities and compare them to women without disabilities. Methods: We analyzed data from the 2002-09 Rhode Island Pregnancy Risk Assessment Monitoring System (PRAMS). Results: Disability prevalence was 6.7% among RI women giving birth during 2002-09. Women with disabilities were more likely to report vaginal bleeding (aOR-1.5, 95%CI 1.2-1.9), pre-term or early labor (aOR-1.7, 95%CI 1.4-2.1, and nausea (aOR-1.5, 95%CI 1.2-1.9) compared to nondisabled women. They were also more likely to experience greater emotional (aOR=1.6, 95%CI=1.3-2.0), partner-related (aOR=2.1, 95%CI=1.7-2.6), financial (aOR=1.6, 95%CI=1.3-2.0) and trauma-related stress (aOR=2.0, 95%CI=1.6-2.5) compared to other women. A more detailed analysis demonstrated that women with disabilities were more likely to report all 13 indicators of maternal stress included in the PRAMS compared to nondisabled women. Women with disabilities were 1.4 times more likely to give birth to a low-birth weight infant (95%CI, 1.2-1.6) and 1.6 times more likely to experience pre-term birth (95%CI, 1.2-2.0) compared to other women after adjusting for age, race/ethnicity, education, marital status and maternal stressors. Conclusion: Women with disabilities are at a higher risk of specific pregnancy complications, maternal stressors and poor birth outcomes.