Factors Associated with Adverse Birth Outcomes in Women with an Intellectual or Other Developmental Disability.

Objective. Women with intellectual or developmental disabilities (IDDs) experience poorer prenatal care and worse perinatal health and birth outcomes than the general population. The purpose of this study is to describe the maternal characteristics and to identify factors associated with the increased risk of adverse birth outcomes among women with an IDD. Methods. Electronic medical records and the Utah Population Database were used to identify demographic and medical characteristics of pregnant individuals between 14 and 45 years old with an IDD and the related birth outcomes. Random-effects logistic regression was used to identify factors that were associated with adverse birth outcomes. Results. A total of 5147 births by 2250 mothers with an IDD (average births per mother = 2.33) were identified. Multigestational pregnancy (twins or triplets) (OR = 32.85, p < 0.01), fewer prenatal care visits (OR = 3.01, <0.01), gestational hypertension (OR = 2.74, p < 0.01), and the presence of a mental illness (OR = 1.28, p = 0.01) had an increased risk for preterm delivery. Associated low birth weight factors included multigestational pregnancy (OR = 22.82, p < 0.01), gestational hypertension (OR = 3.23, p < 0.01), maternal smoking status (OR = 1.54, p < 0.01), fewer prenatal visits (OR = 2.91, p < 0.01), and maternal mental health disorder (OR = 1.66, p < 0.01). Cesarean deliveries were associated with gestational hypertension (OR = 2.33, p < 0.01), Medicaid coverage (OR = 1.76, p < 0.01), and gestational diabetes (OR = 1.42, p < 0.01). Neonatal intensive care unit (NICU) admission was associated with increasing maternal age, multigestational pregnancy, the number of prenatal care visits, hypertension, and maternal mental disorders. Conclusions. These results suggest that sociodemographic factors and health problems put women with an IDD at a higher risk of adverse pregnancy and infant outcomes. Appropriate clinical care and social supports should be utilized to optimize the health and outcomes of this population.