Fertility rates in women with intellectual and developmental disabilities in Wisconsin Medicaid.
Eric Rubenstein, Deborah B Ehrenthal, Jenna Nobles and 5 others
PMID 35430181WHAT IT FOUND
Women with intellectual and developmental disabilities had lower general fertility rates than women without, but similar total fertility rates.
Autistic women and those with cerebral palsy had later peak fertility and lower overall rates than those with intellectual disability.
Key findings
01General fertility rates were lower for women with IDD compared to women without IDD.
02Total fertility rates did not differ statistically between women with and without IDD.
03Fertility patterns varied by IDD type, with autistic women and women with cerebral palsy having later peak fertility and lower total fertility rates than women with intellectual disability.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study is limited to a low-income Medicaid population in Wisconsin, so results may not generalize to women with IDD who have private insurance or live in other regions. IDD status was determined by Medicaid claims codes, which may lead to misclassification, especially for women who enrolled only during pregnancy. The data did not include information on miscarriages or terminations, preventing an assessment of fecundity. Demographic data such as race and urbanicity were not available in the Medicaid enrollment denominator, limiting the ability to control for these factors. Changes in diagnostic coding (ICD-9 to ICD-10) and health care policies during the study period may have affected the identification of IDD and observed trends.
Declared interests
The authors report no conflicts of interest and nothing to disclose. The work was supported by NIH and non-US government research grants.
The easy way to misread this
Do not conclude that all women with IDD have significantly reduced fertility. While general fertility rates were lower, total fertility rates were not statistically different from women without IDD, and patterns varied significantly by disability type.