Neonatal outcomes of mothers with a disability

Objectives — To assess the risk of neonatal complications among women with a physical, sensory, and/or intellectual/developmental disability.

Methods — This population-based cohort study comprised all hospital singleton livebirths in Ontario, Canada from 2003-2018. Newborns of women with a physical (N=144,187), sensory (N=44,988), intellectual/developmental (N=2,207), or ≥2 disabilities (N=8,823) were each compared to 1,593,354 newborns of women without a disability. Outcomes were preterm birth <37 and <34 weeks, small for gestational age birthweight (SGA), large for gestational age birthweight, neonatal morbidity and mortality <28 days after birth, neonatal abstinence syndrome (NAS), and neonatal intensive care unit (NICU) admission. Relative risks (aRR) were adjusted for maternal age, parity, income quintile, rurality, immigrant status, preconception physical and mental health, and prenatal care adequacy.

Results — Risks for neonatal complications were elevated among newborns of women with disabilities compared to those without disabilities. aRRs were especially high for newborns of women with an intellectual/developmental disability, including preterm birth <37 weeks (1.37, 95% CI 1.19-1.58), SGA (1.37, 1.24-1.59), neonatal morbidity (1.42, 1.27-1.60), NAS (1.53, 1.12-2.08), and NICU admission (1.53, 1.40-1.67). The same was seen for newborns of women with ≥2 disabilities, including preterm birth <37 weeks (1.48, 1.39-1.59), SGA (1.13, 1.07-1.20), neonatal morbidity (1.28, 1.20-1.36), NAS (1.87, 1.57-2.23), and NICU admission (1.35, 1.29-1.42).

Conclusions — There is mild to moderate elevated risk for complications among newborns of women with an intellectual/developmental disability, and those with multiple disabilities. These women may need adapted and enhanced preconception and prenatal care, and their newborns may require extra support after birth.