Identifying Pregnant Women With Disabilities and Maternal and Newborn Outcomes

作者：Alka Dev, Willi Horner‐Johnson, Andrew Schaefer, Cecilia Ganduglia‐Cazaban, Thérèse A. Stukel, David C. Goodman, JoAnna K. Leyenaar · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2025.2159 · 被引用次数：3 · 研究领域：Disability Rights and Representation、Pregnancy-related medical research、Spinal Cord Injury Research

Importance: Pregnant women with disabilities are at higher risk of poor pregnancy and birth outcomes. Different methods for identifying disability may affect estimates of health disparities in this population. Objective: To compare pregnancy and birth outcomes among pregnant women using different ways of identifying maternal disability. Design, Setting, and Participants: Retrospective cohort study of linked vital records and maternal and newborn claims for Medicaid-insured live births from January 2010 to December 2014 in Texas. Data analysis was conducted from October 2023 to May 2024. Exposure: Births grouped into 5 maternal cohorts: no identified disability, disability benefits enrollment only, disability diagnostic code only, both benefits enrollment and a diagnostic code, and either disability benefits or a diagnostic code. Main Outcomes and Measures: Mode of delivery (cesarean) and severe maternal morbidity (SMM) were identified from maternal claims. Low birthweight (LBW), preterm birth (PTB), and small for gestational age (SGA) were identified from birth certificates. Modified Poisson regression with robust variance estimators was used to estimate adjusted risk ratios (aRRs) for the association of each of the 5 outcomes with disability group status. Results: Among 921 218 births (mean [SD] maternal age at birth, 25.1 [5.7] years), 895 201 (97.2%) were to mothers with no disability, 6160 (0.7%) were to mothers enrolled in disability benefits only, 17 742 (1.9%) were to ...