PDF(Sci-hub)
Abstract：
Women with intellectual and developmental disabilities (IDD) face increased risk of adverse maternal pregnancy outcomes, yet less is known about infant outcomes.
To examine birth outcomes of infants born to mothers with IDD and assess associations with demographics and IDD-type.
We used data from the Big Data for Little Kids project, which links Wisconsin birth records to Medicaid claims for live births covered by Medicaid from 2007 to 2016. We identified IDD using maternal prepregnancy Medicaid claims and ran Poisson regression (with a log link function) with robust variance clustered by mother to compare prevalence of outcomes between singleton births with and without mothers with IDD. We adjusted the associations for demographic factors and estimated prevalence ratios (PR) as the effect measure. We assessed outcomes by IDD-type (intellectual disability, genetic conditions, cerebral palsy, and autism spectrum disorder) to explore differences by categories of IDD.
Of 267,395 infants, 1696 (0.6%) had mothers with IDD. A greater percentage of infants with mothers with IDD were born preterm (12.8% vs 7.8%; PR 1.64, 95% confidence interval [CI] 1.42, 1.89), small for gestational age (8.5% vs 5.4%; PR 1.42, 95% CI 1.25, 1.61), and died within 12 months of birth (3.2% vs 0.7%; PR 4.93, 95% CI 3.73, 6.43) compared to infants of mothers without IDD. Prevalence ratios were robust to adjustment for demographics factors. Estimates did not meaningfully differ when comparing different IDD-types.
A greater porportion of infants born to mothers with IDD who were covered by Medicaid had poor outcomes compared to other infants. Prevalence of poor infant outcomes was greater for mothers with IDD even after accounting for demographic differences. It is imperative to understand why infants of mothers with IDD are at greater risk so interventions and management can be developed.
To examine birth outcomes of infants born to mothers with IDD and assess associations with demographics and IDD-type.
We used data from the Big Data for Little Kids project, which links Wisconsin birth records to Medicaid claims for live births covered by Medicaid from 2007 to 2016. We identified IDD using maternal prepregnancy Medicaid claims and ran Poisson regression (with a log link function) with robust variance clustered by mother to compare prevalence of outcomes between singleton births with and without mothers with IDD. We adjusted the associations for demographic factors and estimated prevalence ratios (PR) as the effect measure. We assessed outcomes by IDD-type (intellectual disability, genetic conditions, cerebral palsy, and autism spectrum disorder) to explore differences by categories of IDD.
Of 267,395 infants, 1696 (0.6%) had mothers with IDD. A greater percentage of infants with mothers with IDD were born preterm (12.8% vs 7.8%; PR 1.64, 95% confidence interval [CI] 1.42, 1.89), small for gestational age (8.5% vs 5.4%; PR 1.42, 95% CI 1.25, 1.61), and died within 12 months of birth (3.2% vs 0.7%; PR 4.93, 95% CI 3.73, 6.43) compared to infants of mothers without IDD. Prevalence ratios were robust to adjustment for demographics factors. Estimates did not meaningfully differ when comparing different IDD-types.
A greater porportion of infants born to mothers with IDD who were covered by Medicaid had poor outcomes compared to other infants. Prevalence of poor infant outcomes was greater for mothers with IDD even after accounting for demographic differences. It is imperative to understand why infants of mothers with IDD are at greater risk so interventions and management can be developed.
摘要：
患有智力和发育障碍（IDD）的妇女面临不良孕产妇妊娠结局的风险增加，然而，人们对婴儿结局知之甚少。
研究母亲患有IDD的婴儿的出生结局，并评估与人口统计学和IDD类型的关联。
我们使用了儿童大数据项目中的数据，它将威斯康星州的出生记录与2007年至2016年Medicaid涵盖的活产的Medicaid索赔联系起来。我们使用孕妇孕前医疗补助索赔和运行Poisson回归（具有对数链接函数），具有由母亲聚集的稳健方差，以比较有和没有母亲患有IDD的单胎分娩之间的结局患病率。我们调整了人口统计学因素和估计患病率（PR）的关联作为影响指标。我们按IDD类型评估结果(智力障碍，遗传条件,脑瘫,和自闭症谱系障碍），以探讨IDD类别的差异。
在267,395名婴儿中，1696名(0.6%)母亲患有IDD。母亲患有IDD的婴儿中，早产的比例更高（12.8％vs7.8％；PR1.64，95％置信区间[CI]1.42，1.89），小于胎龄（8.5%vs5.4%；PR1.42，95%CI1.25，1.61），与没有IDD的母亲的婴儿相比，在出生后12个月内死亡（3.2％vs0.7％；PR4.93，95％CI3.73，6.43）。患病率比率对于人口统计因素的调整是稳健的。比较不同的IDD类型时，估计值没有明显差异。
与其他婴儿相比，接受医疗补助的IDD母亲所生的婴儿中有更多的婴儿的结局较差。即使考虑了人口统计学差异，患有IDD的母亲的不良婴儿结局的患病率也更高。必须了解为什么患有IDD的母亲的婴儿面临更大的风险，因此可以制定干预措施和管理措施。
研究母亲患有IDD的婴儿的出生结局，并评估与人口统计学和IDD类型的关联。
我们使用了儿童大数据项目中的数据，它将威斯康星州的出生记录与2007年至2016年Medicaid涵盖的活产的Medicaid索赔联系起来。我们使用孕妇孕前医疗补助索赔和运行Poisson回归（具有对数链接函数），具有由母亲聚集的稳健方差，以比较有和没有母亲患有IDD的单胎分娩之间的结局患病率。我们调整了人口统计学因素和估计患病率（PR）的关联作为影响指标。我们按IDD类型评估结果(智力障碍，遗传条件,脑瘫,和自闭症谱系障碍），以探讨IDD类别的差异。
在267,395名婴儿中，1696名(0.6%)母亲患有IDD。母亲患有IDD的婴儿中，早产的比例更高（12.8％vs7.8％；PR1.64，95％置信区间[CI]1.42，1.89），小于胎龄（8.5%vs5.4%；PR1.42，95%CI1.25，1.61），与没有IDD的母亲的婴儿相比，在出生后12个月内死亡（3.2％vs0.7％；PR4.93，95％CI3.73，6.43）。患病率比率对于人口统计因素的调整是稳健的。比较不同的IDD类型时，估计值没有明显差异。
与其他婴儿相比，接受医疗补助的IDD母亲所生的婴儿中有更多的婴儿的结局较差。即使考虑了人口统计学差异，患有IDD的母亲的不良婴儿结局的患病率也更高。必须了解为什么患有IDD的母亲的婴儿面临更大的风险，因此可以制定干预措施和管理措施。
