SurveyDisability and health journal2017

Live birth, miscarriage, and abortion among U.S. women with and without disabilities.

Willi Horner-Johnson, Sheetal Kulkarni-Rajasekhara, Blair G Darney and 2 others

PMID 28431989

WHAT IT FOUND

Among U.S. women who became pregnant, women with disabilities had similar chances of live birth after accounting for age, marital status, Hispanic ethnicity, and health.

Women with complex activity limitations were somewhat more likely to report miscarriage, but other factors explained much of it.

Key findings

01In adjusted analyses, women with disabilities were not significantly different from women without disabilities in live birth.

02Women with complex activity limitations had marginally higher adjusted odds of miscarriage, but age, marital status, Hispanic ethnicity, and health status had stronger associations.

03Reported abortion was not significantly associated with disability after adjustment, and the paper notes substantial underreporting of induced abortion.

STILL TO COME

How it was doneWhat they found

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What it does not show

The study is observational, so it cannot show that disability caused any outcome. Abortion was likely underreported because women were not probed and had to volunteer the outcome. Pregnancies that were never reported were not included, so early miscarriage and abortion counts may be incomplete. Only two years of panel participation were observed, not the full reproductive history. Stillbirths and unspecified non-live births were too few to analyze. Disability was measured by self-reported functional difficulty, not by diagnosis or environmental barriers. The miscarriage finding was marginal and weaker than age, marital status, Hispanic ethnicity, and health status.

Declared interests

The authors report no conflicts of interest. The supplied publication types list research support from NIH, U.S. government, and non-U.S. government sources.

The easy way to misread this

Do not conclude that disability itself causes miscarriage or abortion. After accounting for age, marital status, Hispanic ethnicity, and health, live birth and abortion differences were not significant, and abortion was likely underreported.

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The study

Participants
4513 women aged 18 to 44 who were pregnant during panel participation and had non-missing disability data
Certainty of evidence
Low

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    Cite

    Willi Horner-Johnson, Sheetal Kulkarni-Rajasekhara, Blair G Darney, et al. Live birth, miscarriage, and abortion among U.S. women with and without disabilities. Disability and health journal. 2017.

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