Pregnancy, labor, and delivery outcomes of women with and without spinal cord injury.

Objectives

Compare outcomes in pregnant women with and without Spinal Cord Injury (SCI).

Design

Case study and inception cohort comparison.

Setting

Community, primary care/referral center and university practice.

Participants

Twenty-eight pregnant women (12 with SCI ( = PW-SCI) and 16 without SCI ( = PW-AB)) were enrolled. Six PW-SCI left study and six completed data collection and were matched, by age, parity, and race, with 12 PW-AB (1:2 ratio, respectively). Final analysis included 18 (78%) subjects.Interventions: Not applicable.Main Outcome Measures: Utilizing standardized, templated medical records (published by NIH/NICHHD and DHHS) and self-report, prospective, longitudinal and retrospective details of pregnancy, labor and delivery experiences/complications were recorded for all women and their neonates. Data collection included vital signs, urinalysis, pregnancy-related conditions/complications (i.e. UTIs, hyperglycemia), and labor, delivery, fetal outcomes. For PW-SCI, demographics, occurrences of autonomic dysreflexia (AD), pressure sores, worsening SCI conditions (i.e. spasticity, bladder spasms, lost independence) were recorded.

Results

PW-SCI had statistically greater (P < .05) UTIs than PW-AB (three (50%) to 0 (0%), respectively). One PW-SCI (17%) reported pressure sores and one AD. Three (50%) PW-SCI and 4 (33%) PW-AB experienced a complication at delivery. Newborn mean birth weight (2854 g vs 3578 g; P = 0.12), and length (49.3 vs 45.8 cm; P = 0.32) were lower for PW-SCI than PW-AB. Head circumference was significantly less for PW-SCI than PW-AB (30.3 vs 34.5 cm; P = 0.04).

Conclusions

Women with SCI tend to have more complicated courses of pregnancy, labor and delivery and smaller newborns than non-SCI peers. Neonatal head circumference is significantly smaller.