Citation
Background
Pregnancy and infant outcomes for women with intellectual disability have only been previously investigated in small sample studies. Few have accessed population-based data but one Canadian study found these women were more likely to have their labour induced and experience Caesarean section, partially explained by pre-pregnancy health conditions or pregnancy complications such as pre-eclampsia.
What we did
Using Western Australian population-based data we were able to identify women with an intellectual disability who had given birth. Mothers with intellectual disability were matched by age and Aboriginality to a population sample of mothers without intellectual disability. Pregnancy and birth outcomes were compared for both groups.
What we found
Compared to non-Aboriginal mothers without intellectual disability, non-Aboriginal mothers with intellectual disability were more likely to be of low socio-economic status, be without partner, smoke antenatally and have pre-existing asthma. They had a 1.5 times increased risk of pregnancy complications, such as pre-eclampsia or urinary tract infection. Infants of Aboriginal mothers with ID had twice the risk of preterm birth compared to infants of Aboriginal mothers without intellectual disability. Whilst non-Aboriginal women with intellectual disability and their infants were at risk of poorer pregnancy and birth outcomes compared to those without intellectual disability, we did not see the same contrasts when we compared Aboriginal women with intellectual disability to their peers without intellectual disability. This is likely because Aboriginal women are already likely to be disadvantaged and at risk of poor outcomes.
What it means
Mothers with intellectual disability have higher risks of many modifiable risk factors for poorer maternal and infant health. Navigating medical and maternity services may be challenging for these women. Considering these women are also more likely to be socioeconomically disadvantaged and without a partner, policymakers and healthcare professionals must be aware of the potential for adverse outcomes in mothers with intellectual disability and their probable need for more personalised care and additional time in prenatal visits.