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Horner-Johnson W, Garg B, Darney BG, Biel FM, Caughey AB. Severe maternal morbidity and other perinatal complications among women with physical, sensory, or intellectual and developmental disabilities. Paediatr Perinat Epidemiol 2022; 36:759-768. [PMID: 35437812 PMCID: PMC9398919 DOI: 10.1111/ppe.12873] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Little is known about severe maternal morbidity (SMM) among women with disabilities. OBJECTIVE We assessed differences in SMM and other perinatal complications by presence and type of disability. We hypothesised that SMM and other complications would be more common in births to women with disabilities than to women without disabilities. METHODS We conducted a retrospective cohort study of California births from 2000 to 2012, using birth and death certificate data linked with hospital discharge data. We included singleton deliveries with gestational age of 23-42 weeks. We classified women as having any disability or not and identified disability type (physical, hearing, vision, intellectual/developmental disabilities [IDD]). Our primary outcome was a composite indicator of SMM. Secondary outcomes included additional perinatal complications: gestational hypertension, preeclampsia, gestational diabetes, venous thromboembolism, chorioamnionitis, puerperal endometritis and mental health disorders complicating pregnancy, childbirth or the puerperium. We used modified Poisson regression to obtain covariate-adjusted relative risks (RR) and 95% confidence intervals (CI) for the association of disability status and type with SMM and secondary outcomes. RESULTS Of 5,787,090 deliveries, 33,044 (0.6%) were to women with disabilities. Of these, 311 per 10,000 were complicated by SMM, compared with 84 per 10,000 deliveries to women without disabilities. In multivariable analyses, risk of SMM for births to women with disabilities was nearly three times that for women without disabilities (RR 2.84, 95% CI 2.67, 3.02). Proportion and risk of SMM were greatest for vision disability (793 per 10,000; RR 4.04, 95% CI 3.41, 4.78). Secondary outcomes were also more common among women with disabilities. In particular, more than a third of births to women with IDD (37.4%) were complicated by mental health disorders (versus 2.2% for women without disabilities). CONCLUSION As hypothesised, SMM and other perinatal complications were more common among women with disabilities than among women without disabilities.
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Affiliation(s)
- Willi Horner-Johnson
- Institute on Development and Disability, Oregon Health & Science University, Portland, OR
- OHSU-PSU School of Public Health, Portland, OR
| | - Bharti Garg
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
| | - Blair G. Darney
- OHSU-PSU School of Public Health, Portland, OR
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
| | - Frances M. Biel
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
- Present affiliation: OCHIN, Inc., Portland, OR
| | - Aaron B. Caughey
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
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Diamanti A, Sarantaki A, Gourounti K, Lykeridou A. Perinatal Care in Women with Vision Disorders: a Systematic Review. MÆDICA 2021; 16:261-267. [PMID: 34621349 DOI: 10.26574/maedica.2020.16.2.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective:Maternal healthcare providers are usually unfamiliar and not adequately educated to cover the special needs of women with vision impairment during the perinatal period. Moreover, maternity clinics and hospitals may not be able to provide appropriate support based on the distinct needs of women with vision disorders. A systematic review was conducted with the aim to investigate the gap between those women's particular needs and the health services provided to them as well as the overall barriers that arise during perinatal care of women with vision disorder. Material and methods:We searched for peer-reviewed articles published in any language in two online databases, Medline and Scopus, using the following keywords: "perinatal care", "perinata*", "wom*", "vision disabilit*", "vision disorder*", "visual disorder*", "visual impairment", "blindness". Articles were selected based on four inclusion criteria: (a) studies published over the last ten years, (b) primary researches and conference papers, (c) studies in English language, and (d) adult patient population. Results:A total of 33 studies via Medline and 177 studies via Scopus were initially identified as relevant, but eventually, only three articles were found to meet all inclusion criteria. A systematic analysis of these three studies mainly showed that (a) pregnant women with vision disorders expressed lack of satisfaction for the quality of perinatal care that they received; (b) both hospital facilities and healthcare staff approaches were found incompatible with the specific functional needs of these women; (c) maternity care professionals' training and attitudes need to be modified in order to meet those needs. Conclusion:It is crucial to note that the limited number of relevant studies found by us, which demonstrates by itself the need to conduct more studies in order to draw clearer and safer conclusions. Consequently, more research is required to evaluate how compatible with the functional needs of women with vision disorder the employed maternal healthcare interventions during the perinatal period really are. This would in turn improve perinatal outcomes for both the women and their families.
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Affiliation(s)
- Athina Diamanti
- Department of Midwifery, University of West Attica, Egaleo, Greece
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Nicot R, Hurteloup E, Joachim S, Druelle C, Levaillant JM. Using low-cost 3D-printed models of prenatal ultrasonography for visually-impaired expectant persons. PATIENT EDUCATION AND COUNSELING 2021; 104:2146-2151. [PMID: 33640233 DOI: 10.1016/j.pec.2021.02.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND For visually impaired or blind patients, the experience of pregnancy sets them apart from nondisabled people for whom viewing of the first ultrasound has become a social and emotional milestone. OBJECTIVE We proposed the use of 3D-printed models to allow the societal inclusion of visually impaired or blind expectant parents. PATIENT INVOLVEMENT Visually impaired expectant parents were proposed to touch a 3D printed sensory vector of their prenatal classic ultrasonography. METHODS After a classic ultrasound assessment was performed, selected volumes were processed and 3D-printed with acrylonitrile butadiene styrene. Patient satisfaction was recorded after they manipulated the models. RESULTS A total of 42 prenatal 3D prints were for 12 expectant parents, used during 20 ultrasonographic sessions with visually impaired or blind expectant parents. During 13 of them (65%), it was the mother who was affected by a visual loss whereas the father was the parent affected by the disability during 7 sessions (35%). The parent affected by the disability was congenitally blind and Braille-reader in 9 ultrasonography sessions (45%). All expectant visually impaired or blind parents expressed very significant satisfaction with the use of 3D models for inclusive use. DISCUSSION We have shown that acrylonitrile butadiene styrene-printed models improve the sonographic experience of visually impaired or blind expectant parents. They can thereby perform their own mental representation process by extrapolating sensory information obtained from the 3D tactile support. PRACTICAL VALUE These low-cost 3D-printed models improve the inclusion of visually impaired or blind expectant parents, by offering them a sensory vector of information.
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Affiliation(s)
- Romain Nicot
- Univ. Lille, CHU Lille, INSERM, Oral and Maxillofacial Surgery Department, U1008 - Controlled Drug Delivery Systems and Biomaterial, F-59000 Lille, France; Center for Woman and Fetal Imaging, F-59000, France.
| | - Edwige Hurteloup
- Center for Woman and Fetal Imaging, F-59000, France; Hôpital Privé Armand Brillard, Groupe Ramsay Générale De Santé, F-94130 Nogent-sur-Marne, France
| | | | - Charles Druelle
- Univ. Lille, CHU Lille, Oral and Maxillofacial Surgery Department, F-59000 Lille, France
| | - Jean-Marc Levaillant
- Center for Woman and Fetal Imaging, F-59000, France; Hôpital Privé Armand Brillard, Groupe Ramsay Générale De Santé, F-94130 Nogent-sur-Marne, France
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Smithson CA, McLachlan HL, Newton MS, Smith C, Forster DA. Perinatal outcomes of women with a disability who received pregnancy care through a specialised disability clinic in Melbourne, Australia. Aust N Z J Obstet Gynaecol 2021; 61:548-553. [PMID: 33772765 DOI: 10.1111/ajo.13326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/26/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In Australia, it is estimated that 9.5% of women of childbearing age have a disability; however, little is known about their perinatal outcomes. Disability status is not routinely recorded in perinatal datasets. AIMS To compare the outcomes of women with a disability who received pregnancy care through a specialised disability clinic at the Royal Women's Hospital (the Women's) in Melbourne, Australia with hospital-wide perinatal outcome data. MATERIALS AND METHODS Routinely collected perinatal data for women who received pregnancy care from the 'Women with Individual Needs' (WIN) clinic from 2014-2018 (N = 111) were analysed and then compared with routinely collected electronic hospital data obtained from all women who had given birth at the Women's in 2017 and 2018 (N = 15 024). RESULTS Women who attended the WIN clinic were more likely to have a caesarean section birth (52% vs 32%; P < 0.001) and give birth preterm (17% vs 4%; P < 0.001) than those in the hospital-wide cohort. Their infants were more likely to be low birthweight (20% vs 9%; P < 0.001), require resuscitation (35% vs 11%; P < 0.001), be admitted to the Neonatal Intensive Special Care Unit (29% vs 13%; P < 0.001) and receive formula in hospital (54% vs 28%; P < 0.001) compared to infants in the other group. CONCLUSIONS Routine maternity data collection should include identification of women with a disability to enable appropriate support and to allow further exploration of potential poorer outcomes on a larger sample, to help identify factors amenable to interventions that may improve outcomes.
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Affiliation(s)
- Charlie A Smithson
- Judith Lumley Centre and School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Helen L McLachlan
- Judith Lumley Centre and School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Michelle S Newton
- Judith Lumley Centre and School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Cherise Smith
- The Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Della A Forster
- The Royal Women's Hospital, Melbourne, Victoria, Australia.,Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
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Diress M, Yeshaw Y, Bantihun M, Dagnew B, Ambelu A, Seid MA, Akalu Y. Refractive error and its associated factors among pregnant women attending antenatal care unit at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. PLoS One 2021; 16:e0246174. [PMID: 33577552 PMCID: PMC7880455 DOI: 10.1371/journal.pone.0246174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/14/2021] [Indexed: 11/25/2022] Open
Abstract
Background Refractive error is one of the commonly encountered problems during pregnancy and being the cause of deleterious effects on health. Despite its impacts, there is no evidence on the magnitude and associated factors of refractive error among pregnant women in Ethiopia. This study aimed to determine the prevalence of refractive error and its associated factors among pregnant women attending antenatal care unit at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2020. Methods An institution-based cross-sectional study was employed. An ocular examination was performed using Retinoscope and Snellen’s illiterate “E” chart. The required data were collected using an interviewer-administered questionnaire which comprised socio-demographic, clinical and pregnancy-related variables. EpiData 3.02 and STATA 14 were used for data entry and analysis respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify factors associated with refractive error. Variables with a p-value ≤ 0.05 in the multivariable logistic regression analysis were declared as significantly associated factors with refractive error. Results A total of 401 pregnant women with a median age of 27 (IQR = 24–31) years participated in this study. The overall prevalence of refractive error among the study participants was 35.66% (95% CI: 30.95–40.37). Of the total study participants, ninety-two (22.90%) of them were myopic, forty-five (11.22%) were hyperopic and the rest were antimetropic. Increased maternal age (AOR = 1.31; 95% CI: 1.16–1.48)), increased parity (AOR = 3.17, 95% CI: 1.92–5.25), increased gestational age (AOR = 1.15, 95% CI: 1.08–1.22), and regular use of computers/ watching television (AOR = 6.19, 95% CI: 2.46–15.59) were significantly associated with refractive error. Conclusion The prevalence of refractive error among pregnant women was high where myopia was the most common variety. Advanced maternal age, increased gestational age, increased parity and regular use of computer or watching television were significantly associated with refractive error among pregnant women. Therefore, apart from providing other maternal health services, routine screening and evaluation of pregnant women for refractive error during antenatal care visit is recommended to avoid its negative impacts.
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Affiliation(s)
- Mengistie Diress
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Yigizie Yeshaw
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Minychil Bantihun
- Department of Optometry, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Ambelu
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Department of Human Physiology, School of Medicine, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
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Schiff MA, Doody DR, Crane DA, Mueller BA. Pregnancy outcomes among visually impaired women in Washington State, 1987-2014. Disabil Health J 2020; 14:101057. [PMID: 33384279 DOI: 10.1016/j.dhjo.2020.101057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/17/2020] [Accepted: 12/21/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Women with visual impairment may have reduced ability to access standard care resources, however, information on their pregnancy and neonatal outcomes is limited. OBJECTIVE To assess risk of adverse pregnancy and neonatal outcomes among visually impaired women in Washington State from 1987 to 2014. METHODS We conducted a retrospective cohort study using linked Washington State birth/fetal death hospital discharge records to compare outcomes among women with and without visual impairment noted at their delivery hospitalization. Pregnancy conditions and outcomes evaluated included gestational diabetes, pre-eclampsia, labor induction and cesarean delivery. Neonatal outcomes included preterm delivery and birth weight <2500 g. We assessed length of maternal and infant delivery hospitalization. We performed Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CIs) for each outcome, adjusting for year of delivery, maternal age, and parity. RESULTS Most adverse pregnancy and neonatal outcomes were similar for visually impaired (N = 232) and comparison women (N = 2362). However, visually impaired women had increased risks of severe pre-eclampsia (RR 3.77, 95% CI 1.69-8.43), labor induction (RR 1.33, 95% CI 1.10-1.61) and preterm delivery (RR 1.60, 95% CI 1.06-2.42). They were also more likely to have delivery hospitalizations of 3 or more days following a vaginal (RR 1.86, 95% CI 1.41-2.47). Among cesarean deliveries, infants of visually impaired women had increased risk (RR 1.24, 95% CI 1.02-1.51) of hospitalization for 3 or more days postpartum. CONCLUSION Our findings may be useful for obstetric providers in counseling their visually impaired patients.
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Affiliation(s)
- Melissa A Schiff
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, WA, USA; Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Deborah A Crane
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - Beth A Mueller
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Tarasoff LA, Murtaza F, Carty A, Salaeva D, Hamilton AD, Brown HK. Health of Newborns and Infants Born to Women With Disabilities: A Meta-analysis. Pediatrics 2020; 146:peds.2020-1635. [PMID: 33203648 PMCID: PMC7786829 DOI: 10.1542/peds.2020-1635] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
CONTEXT Women with disabilities are at elevated risk for pregnancy, delivery, and postpartum complications. However, there has not been a synthesis of literature on the neonatal and infant health outcomes of their offspring. OBJECTIVE We examined the association between maternal disability and risk for adverse neonatal and infant health outcomes. DATA SOURCES Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, and PsycINFO were searched from database inception to January 2020. STUDY SELECTION Studies were included if they reported original data on the association between maternal physical, sensory, or intellectual and/or developmental disabilities and neonatal or infant health outcomes; had a referent group of women with no disabilities; were peer-reviewed journal articles or theses; and were written in English. DATA EXTRACTION We used standardized instruments to extract data and assess study quality. DerSimonian and Laird random effects models were used for pooled analyses. RESULTS Thirty-one studies, representing 20 distinct cohorts, met our inclusion criteria. Meta-analyses revealed that newborns of women with physical, sensory, and intellectual and/or developmental disabilities were at elevated risk for low birth weight and preterm birth, with smaller numbers of studies revealing elevated risk for other adverse neonatal and infant outcomes. LIMITATIONS Most studies had moderate (n = 9) or weak quality (n = 17), with lack of control for confounding a common limitation. CONCLUSIONS In future work, researchers should explore the roles of tailored preconception and perinatal care, along with family-centered pediatric care particularly in the newborn period, in mitigating adverse outcomes among offspring of women with disabilities.
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Affiliation(s)
- Lesley A. Tarasoff
- Department of Health and Society and,Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; and
| | | | - Adele Carty
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Dinara Salaeva
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Hilary K. Brown
- Department of Health and Society and,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Shin JE, Cho GJ, Bak S, Won SE, Han SW, Bin Lee S, Oh MJ, Kim SJ. Pregnancy and neonatal outcomes of women with disabilities: a nationwide population-based study in South Korea. Sci Rep 2020; 10:9200. [PMID: 32514114 PMCID: PMC7280207 DOI: 10.1038/s41598-020-66181-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 05/15/2020] [Indexed: 11/29/2022] Open
Abstract
We investigated (1) pregnancy and neonatal outcomes in women with and without disabilities, (2) time trends in deliveries, and (3) risks of pregnancy and neonatal complications among women with various disability types and severity. This was a nationwide population-based study merging the database of the Korea National Health Insurance claims, National Health Screening Program for Infants and Children, and Disability Registration System to compare perinatal outcomes in women with and without disabilities. Pregnancy and neonatal outcomes were analyzed during 2007 and 2015, as were time trends of deliveries. Multivariate logistic regression was used to evaluate risk of perinatal outcomes among women with various disability types and severities. Women with disabilities showed higher rates of cesarean section (aOR, 1.73; 95% CI, 1.69–1.77), hypertensive disorders (aOR, 1.74; 95% CI, 1.63–1.86), placenta abruption (aOR, 1.27; 95% CI, 1.12–1.45), placenta previa (aOR, 1.14; 95% CI, 1.05–1.24), stillbirths (aOR, 1.30; 95% CI, 1.17–1.45), preterm births (aOR, 1.67; 95% CI, 1.57–1.78), and LBW (aOR, 1.87; 95% CI, 1.78–1.97) than those without disabilities. From 2007 to 2015, although delivery rate in women with disabilities decreased steeply compared with that in women without disabilities, the rate of cesarean section increased in women with disabilities. Women with intellectual disability and those with vision impairment had the highest number of perinatal complications among women with various types of disabilities. Women with disability had more adverse pregnancy and neonatal outcomes than those without disabilities. Specific disability types & severities are more vulnerable to specific perinatal complications.
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Affiliation(s)
- Jae Eun Shin
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Korea
| | - Seongeun Bak
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Eun Won
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Won Han
- School of Industrial Management Engineering, Korea University, Seoul, Korea
| | - Soo Bin Lee
- School of Industrial Management Engineering, Korea University, Seoul, Korea
| | - Min-Jeong Oh
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Korea
| | - Sa Jin Kim
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Maternal disability and risk for pregnancy, delivery, and postpartum complications: a systematic review and meta-analysis. Am J Obstet Gynecol 2020; 222:27.e1-27.e32. [PMID: 31306650 DOI: 10.1016/j.ajog.2019.07.015] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/29/2019] [Accepted: 07/09/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Women with disabilities are increasingly becoming pregnant, and growing evidence suggests maternal disability may be associated with increased risk for perinatal complications. OBJECTIVE A systematic review and meta-analysis were undertaken to examine the association between maternal disabilities and risk for perinatal complications. STUDY DESIGN Medline, CINAHL, EMBASE, and PsycINFO were searched from inception to July 2018 for full-text publications in English on pregnancy, delivery, and postpartum complications in women with any disability and those with physical, sensory, and intellectual and developmental disabilities specifically. Searches were limited to quantitative studies with a comparison group of women without disabilities. Reviewers used standardized instruments to extract data from and assess the quality of included studies. Pooled odds ratios and 95% confidence intervals were generated using DerSimonian and Laird random effects models for outcomes with data available from ≥3 studies. RESULTS The review included 23 studies, representing 8,514,356 women in 19 cohorts. Women with sensory (pooled unadjusted odds ratio, 2.85, 95% confidence interval, 0.79-10.31) and intellectual and developmental disabilities (pooled unadjusted odds ratio, 1.10, 95% confidence interval, 0.76-1.58) had elevated but not statistically significant risk for gestational diabetes. Women with any disability (pooled unadjusted odds ratio, 1.45, 95% confidence interval, 1.16-1.82) and intellectual and developmental disabilities (pooled unadjusted odds ratio, 1.77, 95% confidence interval, 1.21-2.60) had increased risk for hypertensive disorders of pregnancy; risk was elevated but not statistically significant for women with sensory disabilities (pooled unadjusted odds ratio, 2.84, 95% confidence interval, 0.85-9.43). Women with any (pooled unadjusted odds ratio, 1.31, 95% confidence interval, 1.02-1.68), physical (pooled unadjusted odds ratio, 1.60, 95% confidence interval, 1.21-2.13), and intellectual and developmental disabilities (pooled unadjusted odds ratio, 1.29, 95% confidence interval, 1.02-1.63) had increased risk for cesarean delivery; risk among women with sensory disabilities was elevated but not statistically significant (pooled unadjusted odds ratio, 1.28, 95% confidence interval, 0.84-1.93). There was heterogeneity in all analyses, and 13 studies had weak-quality ratings, with lack of control for confounding being the most common limitation. CONCLUSION Evidence that maternal disability is associated with increased risk for perinatal complications demonstrates that more high-quality research is needed to examine the reasons for this risk and to determine what interventions could be implemented to support women with disabilities during the perinatal period.
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Nicot R, Joachim S, Levaillant JM. Prenatal tactile three-dimensional ultrasonography for visually impaired women. Acta Obstet Gynecol Scand 2019; 99:555-556. [PMID: 31633797 DOI: 10.1111/aogs.13755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Romain Nicot
- Center for Woman and Fetal Imaging, University of Lille, CHU Lille, INSERM U1008 - Controlled Drug Delivery Systems and Biomaterial, Oral and Maxillofacial Surgery Department, Lille, France
| | | | - Jean-Marc Levaillant
- Hôpital Privé Armand Brillard, Nogent-sur-Marne, Groupe Ramsay Générale de Santé, Center for Woman and Fetal Imaging, Lille, France
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