Canada: Newborns of Women with Disabilities

A recent study in the journal Pediatrics has reported that newborns of women with disabilities are at mild to moderate elevated risk of several birth complications. These women may require adapted and enhanced prenatal and preconception care, and their newborns may need extra support after birth.

Previous studies have suggested that offspring of women with disabilities are at increased risk for low birth weight and preterm birth. The factors explaining the relation were not accounted for there, also, neonatal morbidity and mortality were not assessed. Considering this, Hilary K. Brown, University of Toronto Scarborough, Toronto, Ontario, Canada, and colleagues aimed to assess the risk of neonatal complications among women with a disability in a population-based cohort study.

The study consisted of all hospital singleton live births in Ontario, Canada from 2003 to 2018. Comparisons were made between newborns of women with:

• Physical disabilities (N = 144,187)
• Sensory disabilities (N = 44,988)
• Intellectual or developmental disabilities (N = 2,207)
• ≥2 disabilities (N = 8,823)

with 1,593,354 newborns of women without a disability.

Outcomes included preterm birth <37 and <34 weeks, neonatal morbidity, and mortality, small for gestational age birth weight (SGA), large for gestational age birth weight, neonatal abstinence syndrome (NAS), and NICU admission. Relative risks were adjusted for social, health, and health care characteristics.

Key Findings

• Risks for neonatal complications were elevated among newborns of women with disabilities compared with those without disabilities.
• Adjusted relative risks were especially high for newborns of women with an intellectual or developmental disability, including:
  • Preterm birth <37 weeks (1.37)
  • SGA (1.37)
  • Neonatal morbidity (1.42)
  • NAS (1.53)
  • NICU admission (1.53)
• The same was seen for newborns of women with ≥2 disabilities, including:
  • Preterm birth <37 weeks (1.48)
  • SGA (1.13)
  • Neonatal morbidity (1.28)
  • NAS (1.87)
  • NICU admission (1.35)

To conclude, there is a mild to moderate elevated risk for complications among newborns of women with disabilities.

"These women may need adapting and enhanced preconception and prenatal care, and their newborns may require extra support after birth," the researchers suggest.

Reference

Hilary K. Brown et al, Neonatal Outcomes of Mothers With a Disability, Pediatrics (2022). DOI: 10.1542/peds.2021-055318