Lesley A Tarasoff1,2, Yona Lunsky2,3,4, Simon Chen4, Astrid Guttmann4,5,6,7, Susan M Havercamp8, Susan L Parish9, Simone N Vigod3,4,7,10, Adele Carty7, Hilary K Brown1,4,7,10. 1. Interdisciplinary Centre for Health & Society, University of Toronto Scarborough, Scarborough, Canada. 2. Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada. 3. Department of Psychiatry, University of Toronto, Toronto, Canada. 4. ICES, Toronto, Canada. 5. Hospital for Sick Children, Toronto, Canada. 6. Department of Paediatrics, University of Toronto, Toronto, Canada. 7. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 8. Nisonger Center, The Ohio State University, Columbus, Ohio, USA. 9. College of Health Professions, Virginia Commonwealth University, Richmond, Virginia, USA. 10. Women's College Hospital and Research Institute, Toronto, Canada.
Abstract
Background: There is growing recognition that preconception health, defined as the health of all reproductive-age individuals, impacts reproductive and perinatal outcomes. Although women with disabilities are becoming pregnant at increasing rates, little is known about their preconception health. Our objective was to describe the preconception health characteristics of women with physical, sensory, and intellectual/developmental disabilities and compare these characteristics with women without disabilities. Materials and Methods: We conducted a population-based cross-sectional study of 15- to 44-year-old women with physical (n = 253,184), sensory (n = 93,170), intellectual/developmental (n = 8,986), and multiple disabilities (n = 29,868), and women without these disabilities (n = 2,307,822) using Ontario health administrative data (2017-2018). We described preconception health variables related to social determinants of health, physical health status, psychosocial well-being, history of assault, medication use, and continuity of primary care and compared women with and without disabilities in crude and age-standardized analyses, with standardized differences >0.10 indicating clinically meaningful results. Results: Women with physical, sensory, intellectual/developmental, and multiple disabilities had poorer preconception health than women without disabilities. Disparities were pronounced for physical health status, psychosocial well-being, use of potentially teratogenic medications, and history of assault. Of all groups, women with intellectual/developmental disabilities had the greatest disparities. Conclusion: Further research is needed to identify contributors to poor preconception health among women with disabilities and to develop tailored preconception health interventions to meet their unique needs and experiences.
Background: There is growing recognition that preconception health, defined as the health of all reproductive-age individuals, impacts reproductive and perinatal outcomes. Although women with disabilities are becoming pregnant at increasing rates, little is known about their preconception health. Our objective was to describe the preconception health characteristics of women with physical, sensory, and intellectual/developmental disabilities and compare these characteristics with women without disabilities. Materials and Methods: We conducted a population-based cross-sectional study of 15- to 44-year-old women with physical (n = 253,184), sensory (n = 93,170), intellectual/developmental (n = 8,986), and multiple disabilities (n = 29,868), and women without these disabilities (n = 2,307,822) using Ontario health administrative data (2017-2018). We described preconception health variables related to social determinants of health, physical health status, psychosocial well-being, history of assault, medication use, and continuity of primary care and compared women with and without disabilities in crude and age-standardized analyses, with standardized differences >0.10 indicating clinically meaningful results. Results:Women with physical, sensory, intellectual/developmental, and multiple disabilities had poorer preconception health than women without disabilities. Disparities were pronounced for physical health status, psychosocial well-being, use of potentially teratogenic medications, and history of assault. Of all groups, women with intellectual/developmental disabilities had the greatest disparities. Conclusion: Further research is needed to identify contributors to poor preconception health among women with disabilities and to develop tailored preconception health interventions to meet their unique needs and experiences.
Entities:
Keywords:
disability; health disparities; preconception health
Authors: Momina Khan; Hilary K Brown; Yona Lunsky; Kate Welsh; Susan M Havercamp; Laurie Proulx; Lesley A Tarasoff Journal: Womens Health Issues Date: 2021-09-21
Authors: Eric Rubenstein; Deborah B Ehrenthal; Jenna Nobles; David C Mallinson; Lauren Bishop; Marina C Jenkins; Hsiang-Hui Kuo; Maureen S Durkin Journal: Disabil Health J Date: 2022-03-24 Impact factor: 4.615