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Maternal and offspring outcomes in women with intellectual and developmental disabilities: a population‐based cohort study
Author(s) -
Brown HK,
Cobigo V,
Lunsky Y,
Vigod SN
Publication year - 2017
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14120
Subject(s) - offspring , intellectual disability , cohort , cohort study , psychology , developmental psychology , population , demography , medicine , gerontology , pregnancy , environmental health , psychiatry , biology , sociology , genetics , pathology
Objective To compare the risks for adverse maternal and offspring outcomes in women with and without intellectual and developmental disabilities. Design Population‐based cohort study. Setting Ontario, Canada. Population Singleton obstetrical deliveries to 18‐ to 49‐year‐old women with and without intellectual and developmental disabilities ( n = 3932 in the exposed cohort, n = 382 774 in the unexposed cohort; 2002–2011 fiscal years). Methods Women with intellectual and developmental disabilities were identified based on diagnoses in health administrative data or receipt of disability income support. The unexposed cohort comprised women without intellectual and developmental disabilities. Modified Poisson regression was used to compute adjusted relative risks ( aRR ) and 95% confidence intervals ( CI ) comparing the two cohorts. Main outcome measures Primary maternal outcomes were: gestational diabetes, gestational hypertension, pre‐eclampsia, eclampsia, and venous thromboembolism. Primary offspring outcomes were: preterm birth, small for gestational age, and large for gestational age. Results The exposed cohort, compared with the unexposed cohort, had increased risks for pre‐eclampsia ( aRR 1.47, 95% CI 1.11–1.93) and venous thromboembolism ( aRR 1.60, 95% CI 1.17–2.19). Their offspring had increased risks for preterm birth ( aRR 1.63, 95% CI 1.47–1.80) and small for gestational age ( aRR 1.35, 95% CI 1.25–1.45). Conclusions These findings suggest that there is a need to address modifiable risk factors for adverse outcomes among women with intellectual and developmental disabilities prior to and during pregnancy. Moreover, there is a need to enhance monitoring for maternal and offspring complications in this population. Tweetable abstract Large cohort study: intellectual and developmental disabilities predispose women/babies to adverse outcomes.