Pregnancy and birth outcomes of women with intellectual disability in Sweden: a national register study

Acta Obstet Gynecol Scand. 2012 Dec;91(12):1381-7. doi: 10.1111/j.1600-0412.2012.01509.x. Epub 2012 Sep 18.

Abstract

Objective: To investigate the antenatal health and demographic factors as well as pregnancy and delivery outcomes in women with intellectual disability (ID) in Sweden.

Design: A population-based register study.

Setting: The National Patient Register (NPR) linked to the Medical Birth Register (MBR).

Sample: Women with ID classified as International Classification of Diseases (ICD) 8-10 who gave birth in 1999-2007 (n = 326), identified from the NPR linked to the MBR, were compared with all first-time, singleton mothers without ID or any other psychiatric diagnoses during this period in Sweden (n = 340 624).

Methods: Population-based data were extracted from the NPR and the MBR.

Main outcome measures: Health and socio-demography at first antenatal visit, mode of delivery, pain relief during labor, preterm birth and discharge from hospital.

Results: A higher proportion of women with ID were teenagers (18.4 vs. 3.3%), obese (20.1 vs. 8.6%) and single (36.6 vs. 6.2%) compared with women without ID, and women with ID smoked more often (27.9 vs. 7.9%). Women with ID had more often a preterm birth (12.2 vs. 6.1%), a cesarean section (CS) (24.5 vs. 17.7%) and used less nitrous oxide as pain relief during labor (59.5 vs. 75.8%). Women with ID had a higher risk for preterm birth [odds ratio (OR) 1.68], CS (OR1.55), non-use of nitrous oxide (OR 1.89) and discharge from hospital to a place other than home (OR 2.24).

Conclusion: Pregnant women with ID should be considered a risk group suggesting that better tailored pre- and intrapartum care and support are needed for these women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Chi-Square Distribution
  • Delivery, Obstetric / methods
  • Demography
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intellectual Disability / complications*
  • Intellectual Disability / epidemiology
  • Logistic Models
  • Mothers / psychology*
  • Nitrous Oxide / administration & dosage
  • Obesity / epidemiology
  • Pregnancy
  • Pregnancy Outcome*
  • Registries
  • Risk Factors
  • Smoking / epidemiology
  • Sweden / epidemiology

Substances

  • Nitrous Oxide