TY - JOUR
T1 - Pregnancy complications and maternal birth outcomes in women with intellectual and developmental disabilities in Wisconsin Medicaid
AU - Rubenstein, Eric
AU - Ehrenthal, Deborah B.
AU - Mallinson, David C.
AU - Bishop, Lauren
AU - Kuo, Hsiang Huo
AU - Durkin, Maureen
N1 - Funding Information:
This work was supported by the Eunice Kennedy Shriver National Institute for Child Health and Human Development (R03HD099619- ER; T32 HD007014-42- DM; https://connections. spectrumnews.org/) and the University of Wisconsin-Madison Clinical and Translational Science Award programme through the National Institutes of Health National Center for Advancing Translational Sciences (UL1TR00427-LB, KL2 TR002374-LB; https://ictr.wisc.edu/), by the University of Wisconsin-Madison School of Medicine and Public Health's Wisconsin Partnership Program (DE; https://www.med.wisc. edu/wisconsin-partnership-program/), and by the University of Wisconsin- Madison Institute for Research on Poverty (DE; https://www.irp.wisc. edu/). This study was supported in part by a core grant to the Waisman Center from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54 HD090256- ER, LB, DM; nichd.nih.gov). The funders had no role in study design, data collection and analysis, decision to public, or preparation of the manuscript.
Publisher Copyright:
© 2020 Rubenstein et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/10
Y1 - 2020/10
N2 - Background Women with intellectual and developmental disabilities (IDD) may face greater risk for poor pregnancy outcomes. Our objective was to examine risk of maternal pregnancy complications and birth outcomes in women with IDD compared to women without IDD in Wisconsin Medicaid, from 2007-2016. Methods Data were from the Big Data for Little Kids project, a data linkage that creates an administrative data based cohort of mothers and children in Wisconsin. Women with ≥1 IDD claim the year before delivery were classified as having IDD. Common pregnancy complications and maternal birth outcomes were identified from the birth record. We calculated risk ratios (RR) using log-linear regression clustered by mother. We examined outcomes grouped by IDDtype and explored interaction by race. Results Of 177,691 women with live births, 1,032 (0.58%) had an IDD claim. Of 274,865 deliveries, 1,757 were to mothers with IDD (0.64%). Women with IDD were at greater risk for gestational diabetes (RR: 1.28, 95% CI: 1.0, 1.6), gestational hypertension (RR: 1.22, 95% CI: 1.0, 1.5), and caesarean delivery (RR 1.32, 95% CI: 1.2, 1.4) compared to other women. Adjustment for demographic covariates did not change estimates. Women with intellectual disability were at highest risk of gestational hypertension. Black women with IDD were at higher risk of gestational hypertension than expected under a multiplicative model. Conclusions Women with IDD have increased risk of pregnancy complications and adverse outcomes in Wisconsin Medicaid. Results were robust to adjustment. Unique patterns by IDD types and Black race warrant further exploration.
AB - Background Women with intellectual and developmental disabilities (IDD) may face greater risk for poor pregnancy outcomes. Our objective was to examine risk of maternal pregnancy complications and birth outcomes in women with IDD compared to women without IDD in Wisconsin Medicaid, from 2007-2016. Methods Data were from the Big Data for Little Kids project, a data linkage that creates an administrative data based cohort of mothers and children in Wisconsin. Women with ≥1 IDD claim the year before delivery were classified as having IDD. Common pregnancy complications and maternal birth outcomes were identified from the birth record. We calculated risk ratios (RR) using log-linear regression clustered by mother. We examined outcomes grouped by IDDtype and explored interaction by race. Results Of 177,691 women with live births, 1,032 (0.58%) had an IDD claim. Of 274,865 deliveries, 1,757 were to mothers with IDD (0.64%). Women with IDD were at greater risk for gestational diabetes (RR: 1.28, 95% CI: 1.0, 1.6), gestational hypertension (RR: 1.22, 95% CI: 1.0, 1.5), and caesarean delivery (RR 1.32, 95% CI: 1.2, 1.4) compared to other women. Adjustment for demographic covariates did not change estimates. Women with intellectual disability were at highest risk of gestational hypertension. Black women with IDD were at higher risk of gestational hypertension than expected under a multiplicative model. Conclusions Women with IDD have increased risk of pregnancy complications and adverse outcomes in Wisconsin Medicaid. Results were robust to adjustment. Unique patterns by IDD types and Black race warrant further exploration.
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U2 - 10.1371/journal.pone.0241298
DO - 10.1371/journal.pone.0241298
M3 - Article
C2 - 33108397
AN - SCOPUS:85094824074
SN - 1932-6203
VL - 15
JO - PLoS One
JF - PLoS One
IS - 10 October
M1 - e0241298
ER -
