Prevalence and outcomes of pregnancy in women with disabilities

残疾妇女怀孕的患病率和结局

• 批准号: 8767294
• 负责人: Willi HORNER-JOHNSON
• 金额: $ 23.1万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-25 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8767294
• 关键词: Achievement; Address; Advocate; Age; Attitude; Birth; Birth Certificates; California; Caring; Cessation of life; Characteristics; Childbirth; Consent; Counseling; Data; Data Analyses; Data Sources; Deep Vein Thrombosis; Development; Disabled Persons; Discipline of obstetrics; Ensure; Expenditure; Face; Family Planning; Female of child bearing age; Future; Goals; Health; Health Services Research; Healthcare; Hospitals; Hypertension; Individual; Infant; Infant Health; Infection; Intellectual functioning disability; Intervention Studies; Knowledge; Link; Longevity; Low Birth Weight Infant; Medical; Mission; Modeling; Mothers; National Institute of Child Health and Human Development; Neonatal; Outcome; Parents; Patient Self-Report; Perinatal; Personal Satisfaction; Persons; Population; Population Sizes; Postpartum Period; Preconception Care; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnant Women; Premature Birth; Premature Labor; Prevalence; Prevalence Study; Process; Records; Reporting; Reproductive Process; Research; Resource Allocation; Risk; Risk Factors; Role; Sampling; Small for Gestational Age Infant; Solid; Surveys; United States; Vital Statistics; Woman; adverse outcome; child bearing; disability; evidence base; experience; health care quality; health disparity; interest; medical complication; population based; pregnant; prenatal; public health priorities; public health relevance; reproductive; statistics

DESCRIPTION (provided by applicant): An estimated 8 million U.S. women of childbearing age have a disability. As medical advances have facilitated longer lifespans and more active lives for women with disabilities, interest in childbearing in this population has increased. However, women with disabilities still face substantial barriers to successful and healthy pregnancies. Unfortunately, our understanding of the prevalence of pregnancy, the extent of adverse outcomes, and the factors associated with such outcomes among women with disabilities, remains limited. The statistics that are available suggest greater risk of infections preterm birth, and cesarean delivery for mothers with disabilities. Infants born to women with disabilities are more likely to be low birth weight or small for gestational age, and are at increased risk of perinatal death. However, there is little information at a population level about the course and outcomes of pregnancy in women with disabilities. Furthermore, there is a dearth of data on what proportion of women with disabilities even experience pregnancy. The objective of the proposed project is to address these key knowledge gaps by using both national and state level data to study prevalence and outcomes of pregnancy in women with and without disabilities. Specifically, we will: 1) establish the prevalence of pregnancy among women with disabilities overall, and with particular types of disabilities, compared to women without disabilities~ 2) identify the prevalence and correlates of adverse pregnancy outcomes among women with disabilities~ and 3) determine the independent association of disability with adverse pregnancy outcomes. We will use data from the Medical Expenditure Panel Survey (MEPS) to identify the characteristics of women with disabilities who were pregnant during their panel participation and estimate the size of this population. We will use both the MEPS and hospital discharge and birth certificate data from California to generate new knowledge about outcomes of pregnancy in women with disabilities, risk factors for adverse outcomes, and the unique role of disability in contributing to adverse outcomes above and beyond other risk factors. This exploratory research will move the field forward by utilizing data from large, representative data sources, which will allow us to study relatively rare pregnancy and neonatal outcomes that cannot be researched adequately using smaller samples. Achievement of our aims will provide crucial knowledge about the perinatal issues of women with disabilities, a population that is likely to be particularly vulnerable to adverse outcomes. Our findings will enable clinicians to provide more informed preconception care and counseling for women with disabilities, and may influence family-planning and associated healthcare decisions of women with disabilities. Our results will also have important implications for enhancing prenatal, delivery, and postpartum care for mothers with disabilities and their infants.

描述（由申请人提供）：估计有800万美国育龄妇女有残疾。随着医疗进步促进了更长的寿命和对残疾妇女的更多积极生活，对这一人群的生育兴趣也有所增加。但是，残疾妇女仍然面临成功和健康怀孕的重大障碍。不幸的是，我们对怀孕的患病率，不良后果的程度以及与残疾妇女中这种结果相关的因素的理解仍然有限。可用的统计数据表明，早产的感染风险更大，残疾母亲的剖宫产分娩。残疾妇女出生的婴儿更可能是低出生体重或胎龄小的婴儿，并且围产期死亡的风险增加。但是，人口一级的信息很少 残疾女性怀孕的病程和结局。此外，关于残疾妇女的比例甚至是怀孕的数据。拟议项目的目的是通过使用国家和州一级的数据来研究这些关键知识差距，以研究有和没有残疾的妇女怀孕的患病率和妊娠结局。具体而言，我们将：1）与没有残疾的妇女相比，确定残疾女性以及特定类型的残疾女性怀孕的患病率〜2）确定残疾妇女不良怀孕结局的患病率和相关性〜和3）确定残疾与不良怀孕的独立关联。我们将使用医疗支出小组调查（MEP）中的数据来确定在小组参与期间怀孕的残疾妇女的特征，并估计该人群的规模。我们将同时使用来自加利福尼亚州的MEP和医院出院和出生证书数据来产生有关残疾妇女怀孕的新知识，不良结果的危险因素以及残疾在促成不利结果以外和其他危险因素以外的不良后果方面的独特作用。这项探索性研究将通过利用来自大型代表性数据源的数据来推动该领域的发展，这将使我们能够研究相对较少的妊娠和新生儿结局，而这些结果无法使用较小的样本进行充分研究。实现我们的目标将提供有关残疾妇女的围产期问题的关键知识，该人口可能特别容易受到不利结果的影响。我们的发现将使临床医生能够为残疾妇女提供更明智的见面护理和咨询，并可能影响残疾妇女的家庭计划和相关的医疗保健决定。我们的结果还将对为残疾母亲及其婴儿增强产前，分娩和产后护理具有重要意义。