Concurrent emergency department use by a new mother with a disability and her newborn

Objectives — To assess the risk of concurrent emergency department use (Co-ED) among women with a preexisting disability and their infants.

Methods — This population-based cohort study was completed in Ontario, Canada. Included were all mother–infant pairs with a hospital delivery, 2008–2023. Those with a maternal physical (N = 152 171), sensory (N = 54 716), or intellectual/developmental (N = 2913) disability or multiple disabilities (N = 11 800) were compared with those with no disability (N = 1 548 178). Multinomial logistic regression–generated odds ratios (ORs) and 95% CI for Co-ED (ie, mother and infant both had emergency department (ED) visits within 90 days after hospital discharge), a maternal ED visit only, or an infant ED visit only were calculated, each vs no ED visit. Models were adjusted for maternal age, parity, income quintile, rurality, immigration status, and delivery year.

Results — Co-ED was more likely among women with (5.4%) than without (3.4%) a disability (adjusted OR [aOR], 1.66; 95% CI, 1.62–1.71). The median number of days between the first maternal and first infant ED visit was 19 (IQR, 4–41) days, and 18.3% occurred within 24 hours of each other. The aOR for maternal ED visit alone was 1.38 (95% CI, 1.35–1.40) and 1.20 (95% CI, 1.19–1.22) for an infant ED visit alone.

Conclusions — Co-ED was an important outcome for all mother–infant pairs, particularly so for mothers with a disability, of whom about 1 in 20 experienced Co-ED. These dyads may benefit from careful postdischarge planning during the birth hospital stay and enhanced outpatient health care.