Pregnancy and Neonatal Outcomes Among Women With Intellectual and Developmental Disabilities: A Systematic and Literature Review.

Substantial health and social inequalities exist among women with intellectual and developmental disabilities (IDD), which can have a negative impact on maternal and neonatal health. For this review, an extensive search of the databases PubMed, Embase, Scopus, and Cochrane Library was performed from their inception to June 2026. Retrospective studies on outcomes of mothers and babies with IDD were included if they met the inclusion criteria. The quality was evaluated with the Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. Retrospective cohort studies comprising more than 8.4 million pregnancies were included. Compared with women without IDD, women with IDD had higher rates of preterm birth (7.4%-2 3.3% vs. 5.0%-11.6%), small for gestational age (SGA) infants (13.1%-17.0%), low birth weight (LBW) (15.1%-15.4%), and neonatal intensive care unit (NICU) admission (13.3%-20.6% vs. 5.0%-11.7%). Adverse neonatal outcomes were also more common, including stillbirth (aOR=2.40, 95% CI 1.70-3.40), neonatal death (aRR=2.31, 95% CI 1.38-3.87), and infant mortality (PR=4.93, 95% CI 3.73-6.43). Maternal IDD was associated with severe maternal morbidity (aRR=1.61-4.82) and maternal mortality (aRR=11.19, 95% CI 2.40-52.19). The results indicate a need to provide targeted prenatal care and multidisciplinary interventions to improve the outcomes of women with IDD and their infants.