Birth outcomes among US women with intellectual and developmental disabilities.
Ilhom Akobirshoev, Susan L Parish, Monika Mitra and 1 others
PMID 28404230WHAT IT FOUND
Women with intellectual and developmental disabilities had significantly higher odds of preterm birth, low birth weight, and stillbirth compared to other women.
This risk persisted even after adjusting for age, race, income, and comorbidities. Clinicians should anticipate these adverse outcomes in this population.
Key findings
01After adjusting for covariates including maternal age, race, insurance, and comorbidities, deliveries to women with IDD were significantly more likely to result in preterm birth, low birth weight, and stillbirth.
02Women with IDD had nearly four times the unadjusted odds of stillbirth and more than two times the unadjusted odds of preterm birth and low birth weight compared to women without IDD.
03The study could not determine the types of perinatal care received or other causes for the observed differences in birth outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study relied on ICD-9 codes, which may have missed some cases of IDD, suggesting the number of affected deliveries is likely an undercount. The unit of analysis was the hospitalization, not the individual woman, so a woman with multiple deliveries in the same year was counted more than once. Data was limited to hospital records, so the study could not account for marital status, out-of-hospital births, or the specific quality and type of prenatal care received. The study cannot establish causality; it identifies an association between IDD and adverse outcomes but does not explain why these outcomes occur.
Declared interests
No financial disclosures were reported by the authors.
The easy way to misread this
Do not assume this study proves that IDD itself biologically causes these birth complications. The data is observational and lacks information on prenatal care quality, social support, and marital status, so the higher risk may be driven by unmeasured healthcare disparities or social determinants rather than the disability alone.