Skip to main content

Advertisement

Log in

Health Risk Factors and Mental Health Among US Women with and without Chronic Physical Disabilities by Whether Women are Currently Pregnant

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Growing numbers of reproductive-age US women with chronic physical disabilities (CPD) raise questions about their pregnancy experiences. Little is known about the health risks of women with versus without CPD by current pregnancy status. We analyzed cross-sectional, nationally-representative National Health Interview Survey data from 2006 to 2011, which includes 47,629 civilian, noninstitutionalized women ages 18–49. NHIS asks about specified movement difficulties, current pregnancy, and various health and health risk indicators, including tobacco use and body mass index (BMI). We used responses from eight movement difficulty and other questions to identify women with mobility difficulties caused by chronic physical health conditions. Across all women regardless of CPD, women reporting current pregnancy are significantly less likely to currently smoke tobacco and report certain mental health problems. Among currently pregnant women only, women with CPD are more likely to smoke cigarettes every day (12.2 %) versus 6.3 % for pregnant women without CPD (p ≤ 0.001). Among currently pregnant women, 17.7 % of women with CPD have BMIs in the non-overweight range, compared with 40.1 % of women without CPD (p ≤ 0.0001). Currently pregnant women with CPD are significantly more likely to report having any mental health problems, 66.6 % compared with 29.7 % among women without CPD (p ≤ 0.0001). For all women, currently pregnant women appear to have fewer health risks and mental health concerns than nonpregnant women. Among pregnant women, women with CPD have higher rates than other women of health risk factors that could affect maternal and infant outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Altman, B., & Bernstein, A. (2008). Disability and Health in the United States, 2001–2005. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  2. Chevarley, F. M., Thierry, J. M., Gill, C. J., Ryerson, A. B., & Nosek, M. A. (2006). Health, preventive health care, and health care access among women with disabilities in the 1994–1995 National Health interview survey, supplement on disability. Womens Health Issues., 16(6), 297–312.

    Article  PubMed  Google Scholar 

  3. Robinson-Whelen, S., Taylor, H. B., Hughes, R. B., & Nosek, M. A. (2013). Depressive symptoms in women with physical disabilities: Identifying correlates to inform practice. Archives of Physical Medicine and Rehabilitation, 94(12), 2410–2416.

    Article  PubMed  Google Scholar 

  4. Hughes, R. B., Taylor, H. B., Robinson-Whelen, S., & Nosek, M. A. (2005). Stress and women with physical disabilities: Identifying correlates. Womens Health Issues, 15(1), 14–20.

    Article  PubMed  Google Scholar 

  5. Hughes, R. B., Robinson-Whelen, S., Taylor, H. B., Petersen, N. J., & Nosek, M. A. (2005). Characteristics of depressed and nondepressed women with physical disabilities. Archives of Physical Medicine and Rehabilitation, 86(3), 473–479.

    Article  PubMed  Google Scholar 

  6. Wisdom, J. P., McGee, M. G., Horner-Johnson, W., Michael, Y. L., Adams, E., & Berlin, M. (2010). Health disparities between women with and without disabilities: A review of the research. Social Work in Public Health, 25(3), 368–386.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Iezzoni, L. I., McCarthy, E. P., Davis, R. B., Harris-David, L., & O’Day, B. (2001). Use of screening and preventive services among women with disabilities. American Journal of Medical Quality, 16(4), 135–144.

    Article  CAS  PubMed  Google Scholar 

  8. Tong, V. T., Jones, J. R., Dietz, P. M., D’Angelo, D., & Bombard, J. M. (2009). Centers for Disease Control and Prevention (CDC). Trends in smoking before, during, and after pregnancy—pregnancy risk assessment monitoring system (PRAMS), United States, 31 sites, 2000–2005. MMWR Surveillance Summary, 58(4), 1–29.

    Google Scholar 

  9. Tong, V. T., Dietz, P. M., Morrow, B., D’Angelo, D. V., Farr, S. L., Rockhill, K. M., & England, L. J. (2013). Centers for Disease Control and Prevention (CDC). Trends in smoking before, during, and after pregnancy—pregnancy risk assessment monitoring system, united states, 40 sites, 2000–2010. MMWR Surveillance Summary, 62(6), 1–19.

    Google Scholar 

  10. Dietz, P. M., England, L. J., Shapiro-Mendoza, C. K., Tong, V. T., Farr, S. L., & Callaghan, W. M. (2010). Infant morbidity and mortality attributable to prenatal smoking in the U.S. American Journal of Preventive Medicine, 39(1), 45–52.

    Article  PubMed  Google Scholar 

  11. Adams, E. K., Melvin, C. L., Raskind-Hood, C., Joski, P. J., & Galactionova, E. (2011). Infant delivery costs related to maternal smoking: An update. Nicotine & Tobacco Research, 13(8), 627–637.

    Article  Google Scholar 

  12. Kim, S. Y., England, L. J., Kendrick, J. S., Dietz, P. M., & Callaghan, W. M. (2009). The contribution of clinic-based interventions to reduce prenatal smoking prevalence among US women. American Journal of Public Health, 99(5), 893–898.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Lumley, J., Chamberlain, C., Dowswell, T., Oliver, S., Oakley, L., & Watson, L. (2009). Interventions for promoting smoking cessation during pregnancy. Cochrane Database System Review, (3), CD001055. doi:10.1002/14651858.CD001055.pub3.

  14. Mitra, M., Lu, E., & Diop, H. (2012). Smoking among pregnant women with disabilities. Womens Health Issues, 22(2), e233–e239.

    Article  PubMed  Google Scholar 

  15. Nohr, E. A., Villamor, E., Vaeth, M., Olsen, J., & Cnattingius, S. (2012). Mortality in infants of obese mothers: Is risk modified by mode of delivery? Acta Obstetricia et Gynecologica Scandinavica, 91(3), 363–371.

    Article  PubMed  Google Scholar 

  16. Cnattingius, S., Villamor, E., Johansson, S., Edstedt Bonamy, A. K., Persson, M., Wikstrom, A. K., et al. (2013). Maternal obesity and risk of preterm delivery. JAMA, 309(22), 2362–2370.

    Article  CAS  PubMed  Google Scholar 

  17. Ehrenberg, H. M., Mercer, B. M., & Catalano, P. M. (2004). The influence of obesity and diabetes on the prevalence of macrosomia. American Journal of Obstetrics and Gynecology, 191(3), 964–968.

    Article  CAS  PubMed  Google Scholar 

  18. Kristensen, J., Vestergaard, M., Wisborg, K., Kesmodel, U., & Secher, N. J. (2005). Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG, 112(4), 403–408.

    Article  PubMed  Google Scholar 

  19. Joy, S., Istwan, N., Rhea, D., Desch, C., & Stanziano, G. (2009). The impact of maternal obesity on the incidence of adverse pregnancy outcomes in high-risk term pregnancies. American Journal of Perinatology, 26(5), 345–349.

    Article  PubMed  Google Scholar 

  20. Magann, E. F., Doherty, D. A., Sandlin, A. T., Chauhan, S. P., & Morrison, J. C. (2013). The effects of an increasing gradient of maternal obesity on pregnancy outcomes. Australian and New Zealand Journal of Obstetrics and Gynaecology, 53(3), 250–257.

  21. Minsart, A. F., Buekens, P., De Spiegelaere, M., Englert, Y. (2013) Neonatal outcomes in obese mothers: A population-based analysis. BMC Pregnancy Childbirth. 13(36), 2393-13-36.

  22. Committee on Obstetric Practice. (2013). Committee opinion no. 549. obesity in pregnancy. Obstetrics and Gynecology, 121, 213–217.

    Google Scholar 

  23. Gaillard, A., Le Strat, Y., Mandelbrot, L., Keita, H., & Dubertret, C. (2014). Predictors of postpartum depression: Prospective study of 264 women followed during pregnancy and postpartum. Psychiatry Research, 215(2), 341–346.

    Article  PubMed  Google Scholar 

  24. Milgrom, J., Gemmill, A. W., Bilszta, J. L., Hayes, B., Barnett, B., Brooks, J., et al. (2008). Antenatal risk factors for postnatal depression: A large prospective study. Journal of Affective Disorders, 108(1–2), 147–157.

    Article  PubMed  Google Scholar 

  25. Institute of Medicine, Committee on Disability in America Board on Health Sciences Policy, Field, M. J., Jette, A. M., (Eds.) (2007). The future of disability in America. Washington, DC: The National Academies Press.

  26. Iezzoni, L. I., Yu, J., Wint, A. J., Smeltzer, S. C., & Ecker, J. L. (2013). Prevalence of current pregnancy among U.S. women with and without chronic physical disabilities. Medical Care, 51(6), 555–562.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Iezzoni, L. I., Yu, J., Wint, A. J., Smeltzer, S. C., & Ecker, J. L. (2014). Conditions causing disability and current pregnancy among US women with chronic physical disabilities. Medical Care, 52(1), 20–25.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Iezzoni, L. I., Yu, J., Wint, A. J., Smeltzer, S. C., & Ecker, J. L. (2014). General health, health conditions, and current pregnancy among U.S. women with and without chronic physical disabilities. Disability and Health Journal, 7(2), 181–188.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Division of Health Interview Statistics, National Center for Health Statistics. 2008 National Health Interview Survey (NHIS). Public Use Data Release. NHIS Survey Description. Hyattsville, MD: Centers for Disease Control and Preventions, U.S. Department of Health and Human Services, June 2009.

  30. Iezzoni, L. I., & O’Day, B. L. (2006). More than ramps. A guide to improving health care quality and access for people with disabilities. New York: Oxford University Press.

    Google Scholar 

  31. Iezzoni, L. I., Kilbridge, K., & Park, E. R. (2010). Physical access barriers to care for diagnosis and treatment of breast cancer among women with mobility impairments. Oncology Nursing Forum, 37(6), 711–717.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Dietz, P. M., Homa, D., England, L. J., Burley, K., Tong, V. T., Dube, S. R., & Bernert, J. T. (2011). Estimates of nondisclosure of cigarette smoking among pregnant and nonpregnant women of reproductive age in the united states. American Journal of Epidemiology, 173(3), 355–359.

    Article  PubMed  Google Scholar 

  33. Tong, V. T., Dietz, P. M., Farr, S. L., D’Angelo, D. V., & England, L. J. (2013). Estimates of smoking before and during pregnancy, and smoking cessation during pregnancy: Comparing two population-based data sources. Public Health Reports, 128(3), 179–188.

    PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

Eunice Kennedy Shriver National Institute for Child Health and Human Development, Grant No. 5R21HD068756-02.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lisa I. Iezzoni.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Iezzoni, L.I., Yu, J., Wint, A.J. et al. Health Risk Factors and Mental Health Among US Women with and without Chronic Physical Disabilities by Whether Women are Currently Pregnant. Matern Child Health J 19, 1364–1375 (2015). https://doi.org/10.1007/s10995-014-1641-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-014-1641-6

Keywords

Navigation