Prolonged postpartum length of hospital stay among women with disabilities.
Willi Horner-Johnson, Blair G Darney, Frances M Biel and 1 others
PMID 32402792WHAT IT FOUND
Women with disabilities had significantly higher odds of prolonged postpartum hospital stays compared to women without disabilities, even after accounting for mode of delivery.
The association was strongest for women with vision disabilities and remained significant for all disability types except hearing in adjusted prevalence analyses.
Key findings
01Women with disabilities had significantly elevated adjusted odds of prolonged length of stay compared to women without disabilities.
02Adjusted odds of prolonged length of stay were highest for women with vision disabilities, followed by women with intellectual/developmental disabilities, and women with physical disabilities.
03The adjusted prevalence of prolonged length of stay remained significantly higher in all disability groups except hearing, compared to the no disability group.
STILL TO COME
How it was doneWhat they found
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What it does not show
Disability status was defined solely by ICD-9 diagnosis codes from delivery records, which may misclassify women without functional limitations into the disability category or women with functional limitations into the no disability category. The study did not have access to potentially relevant diagnoses from a woman's prior medical history, likely identifying only disabilities perceived as important to clinical management of pregnancy and delivery. Results may not be generalizable to less obvious or severe disabilities. The study did not control for delivery complications themselves in regression models, as these are directly on the causal pathway to longer length of stay. The study used complete case analyses, though missing data on covariates did not exceed 10%.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not assume that prolonged hospital stays for women with disabilities are solely due to higher rates of cesarean delivery. The study found that lengths of stay were longer for women with disabilities for each type of delivery, and the association remained significant even after accounting for mode of delivery.