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.
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Altman, B., & Bernstein, A. (2008). Disability and Health in the United States, 2001–2005. Hyattsville, MD: National Center for Health Statistics.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Mitra, M., Lu, E., & Diop, H. (2012). Smoking among pregnant women with disabilities. Womens Health Issues, 22(2), e233–e239.
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.
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.
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.
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.
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.
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.
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.
Committee on Obstetric Practice. (2013). Committee opinion no. 549. obesity in pregnancy. Obstetrics and Gynecology, 121, 213–217.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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Eunice Kennedy Shriver National Institute for Child Health and Human Development, Grant No. 5R21HD068756-02.
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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
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DOI: https://doi.org/10.1007/s10995-014-1641-6