Pregnancy among US women: differences by presence, type, and complexity of disability

• Published in: American journal of obstetrics and gynecology 2016-04, Vol.214 (4), p.529.e1-529.e9
• Main Authors: Horner-Johnson, Willi, PhD, Darney, Blair G., PhD, MPH, Kulkarni-Rajasekhara, Sheetal, MBBS, MPH, Quigley, Brian, MS, Caughey, Aaron B., MD, MPP, MPH, PhD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Cross-Sectional Studies; Disabled Persons - statistics & numerical data; Female; Health Surveys; Humans; Multivariate Analysis; Obstetrics and Gynecology; people with disabilities; population-based data; Pregnancy; Pregnancy Rate; Severity of Illness Index; United States - epidemiology; women; Young Adult
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2015.10.929

Background Approximately 12% of women of reproductive age have some type of disability. Very little is known about sexual and reproductive health issues among women with disabilities, including what proportion of women with disabilities experience pregnancy. Data on pregnancy are important to inform needs for preconception and pregnancy care for women with disabilities. Objective The purpose of this study was to describe the occurrence of pregnancy among women with various types of disability and with differing levels of disability complexity, compared with women without disabilities, in a nationally representative sample. Study Design We conducted cross-sectional analyses of 2008–2012 Medical Expenditure Panel Survey annualized data to estimate the proportion of women aged 18–44 years with and without disabilities who reported a pregnancy during 1 year of participation on the survey panel. We used a multivariable logistic regression to test the association of pregnancy with presence, type, and complexity of disability, controlling for other factors associated with pregnancy. Results Similar proportions of women with and without disabilities reported a pregnancy (10.8% vs 12.3%, with 95% confidence intervals overlapping). Women with the most complex disabilities (those that impact activities such as self-care and work) were less likely to have been pregnant (adjusted odds ratio, 0.69, 95% confidence interval, 0.52–0.93), but women whose disabilities affected only basic actions (seeing, hearing, movement, cognition) did not differ significantly from women with no disabilities. Conclusion Women with a variety of types of disabilities experience pregnancy. Greater attention is needed to the reproductive health care needs of this population to ensure appropriate contraceptive, preconception, and perinatal care.