Pregnancy outcomes in women with intellectual disability. A cohort study using linked Swedish population-based registers (IDcare)
Edvardsson, Kristina ; Mogren, Ingrid and Axmon, Anna LU
(2024)
The 17th IASSIDD World Congress
- Abstract
- Background: Women with intellectual disability (ID) may encounter barriers to exercising reproductive agency, self-care during pregnancy, and accessing healthcare to optimize pregnancy outcomes. However, there is to date little evidence to guide policy and practice. We aim to fill this identified knowledge gap by examining pregnancy outcomes among women with ID in comparison with women from the general population.
Methods: Data were drawn from the IDcare cohort, in which all people living in Skåne in 2014 were included. The original study cohorts comprised 5939 women with ID and 620032 women from the general population (gPop; comparison). Of these, 382 and 66732, respectively, had at least one delivery during the study period... (More) - Background: Women with intellectual disability (ID) may encounter barriers to exercising reproductive agency, self-care during pregnancy, and accessing healthcare to optimize pregnancy outcomes. However, there is to date little evidence to guide policy and practice. We aim to fill this identified knowledge gap by examining pregnancy outcomes among women with ID in comparison with women from the general population.
Methods: Data were drawn from the IDcare cohort, in which all people living in Skåne in 2014 were included. The original study cohorts comprised 5939 women with ID and 620032 women from the general population (gPop; comparison). Of these, 382 and 66732, respectively, had at least one delivery during the study period (2014-2021). To avoid statistical dependence, our analyses were limited to the first recorded pregnancy for each woman. For each investigated pregnancy outcome, we estimated the risk associated with the ID cohort compared to the gPop cohort, using Poisson regression to determine relative risks (RRs).
Findings: Women with ID were younger than the general population at the first recorded pregnancy (27 vs 31 years, p<0.001). They were however as likely to only have one delivery during the study period (68% vs 64%; RR 1.05). The most common mode of delivery in both groups was single spontaneous delivery (73.6% in the ID cohort and 74.7% in the gPop cohort), followed by single delivery by caesarean delivery (17.3% and 16.4%; RR 1.23), single delivery by forceps and vacuum extraction (7.3% and 7.2%; RR 1.01), multiple delivery (n<5 and 1.4%), and other assisted single delivery (n<5 and 0.3%). However, women with ID were more likely to experience failed induction of labor (26% vs 20%; RR 1.28).
Conclusions: The disparities in outcomes support the need for improved pregnancy care and support for women with ID. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/c4ad0b9b-f0f7-4961-b4e1-4bebca385828
- author
- Edvardsson, Kristina
; Mogren, Ingrid
and Axmon, Anna
LU
- organization
- publishing date
- 2024-08-05
- type
- Contribution to conference
- publication status
- published
- subject
- conference name
- The 17th IASSIDD World Congress
- conference location
- Chicago, United States
- conference dates
- 2024-08-05 - 2024-08-08
- project
- Health care utilization in primary and specialist care among people with intellectual disability: A longitudinal register study
- Support, health care, end-of-life care, and causes of death among people with intellectual disability: Effects of the Covid-19 pandemic
- language
- English
- LU publication?
- yes
- id
- c4ad0b9b-f0f7-4961-b4e1-4bebca385828
- alternative location
- https://www.lupop.lu.se/idcare_iassidd2024_pregnancy
- date added to LUP
- 2024-08-12 15:33:20
- date last changed
- 2024-08-13 07:39:30
@misc{c4ad0b9b-f0f7-4961-b4e1-4bebca385828,
abstract = {{Background: Women with intellectual disability (ID) may encounter barriers to exercising reproductive agency, self-care during pregnancy, and accessing healthcare to optimize pregnancy outcomes. However, there is to date little evidence to guide policy and practice. We aim to fill this identified knowledge gap by examining pregnancy outcomes among women with ID in comparison with women from the general population. <br/><br/>Methods: Data were drawn from the IDcare cohort, in which all people living in Skåne in 2014 were included. The original study cohorts comprised 5939 women with ID and 620032 women from the general population (gPop; comparison). Of these, 382 and 66732, respectively, had at least one delivery during the study period (2014-2021). To avoid statistical dependence, our analyses were limited to the first recorded pregnancy for each woman. For each investigated pregnancy outcome, we estimated the risk associated with the ID cohort compared to the gPop cohort, using Poisson regression to determine relative risks (RRs).<br/><br/>Findings: Women with ID were younger than the general population at the first recorded pregnancy (27 vs 31 years, p<0.001). They were however as likely to only have one delivery during the study period (68% vs 64%; RR 1.05). The most common mode of delivery in both groups was single spontaneous delivery (73.6% in the ID cohort and 74.7% in the gPop cohort), followed by single delivery by caesarean delivery (17.3% and 16.4%; RR 1.23), single delivery by forceps and vacuum extraction (7.3% and 7.2%; RR 1.01), multiple delivery (n<5 and 1.4%), and other assisted single delivery (n<5 and 0.3%). However, women with ID were more likely to experience failed induction of labor (26% vs 20%; RR 1.28). <br/><br/>Conclusions: The disparities in outcomes support the need for improved pregnancy care and support for women with ID.}},
author = {{Edvardsson, Kristina and Mogren, Ingrid and Axmon, Anna}},
language = {{eng}},
month = {{08}},
title = {{Pregnancy outcomes in women with intellectual disability. A cohort study using linked Swedish population-based registers (IDcare)}},
url = {{https://www.lupop.lu.se/idcare_iassidd2024_pregnancy}},
year = {{2024}},
}