Women with intellectual and developmental disabilities have nearly double the rate of having another baby within a year of delivering compared to women without such disabilities, according to a new study published in CMAJ (Canadian Medical Association Journal).
Rapid repeat pregnancy within one year of a previous live birth is associated with smaller babies, preterm birth, neonatal death and other adverse effects. It also indicates a lack of access to reproductive health care, such as pregnancy planning and contraception.
About one in 100 adults have an intellectual or developmental disability, such as autism-spectrum disorder, Down syndrome, fetal alcohol syndrome and other nonspecific conditions that cause intellectual and developmental limitations.
Researchers analyzed data on 2855 women with intellectual and developmental disabilities compared with 923 367 women without such disabilities who had a live birth between 2002 and 2013. They found that 7.6% of women with these disabilities had another baby within a year, compared to 3.9% of women without these disabilities.
“Women with intellectual and developmental disabilities are more likely than those without such disabilities to be young and disadvantaged in each marker of social, health, and health care disparities. They experience high rates of poverty and chronic physical and mental illness, and have poor access to primary care,” says Hilary Brown, an adjunct scientist at Institute for Clinical Evaluative Sciences (ICES) and lead author of the study.
Rapid repeat pregnancies in women with intellectual and developmental disabilities ended in induced abortion (49%), live birth (33%) and pregnancy loss (18%) compared with induced abortion (59%), pregnancy loss (22%) and live birth (19%) in women without these disabilities.
“This study shows that current efforts to promote reproductive health might not be reaching women with intellectual and developmental disabilities and that there is a lot more we can do to educate and support these women in relation to pregnancy planning and contraception,” adds Brown.
The study was conducted by researchers from University of Toronto; Women’s College Research Institute; ICES; St. Michael’s Hospital and Centre for Addiction and Mental Health, Toronto, Ontario.
It was funded by the Province of Ontario through its research grants program.
- Hilary K. Brown, Joel G. Ray, Ning Liu, Yona Lunsky, Simone N. Vigod. Rapid repeat pregnancy among women with intellectual and developmental disabilities: a population-based cohort study. Canadian Medical Association Journal, 2018; 190 (32): E949 DOI: 10.1503/cmaj.170932