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Higher risks for intellectually and developmentally disabled moms

August 22, 2016

Hilary  Brown
Hilary Brown, PhD

Women with intellectual and developmental disabilities are at increased risk for serious pregnancy complications, according to a study by Hilary Brown, PhD, a postdoctoral fellow at the Women’s College Research Institute (WCRI). Their newborns experience complications as well.

Intellectual and developmental disabilities include a broad range of conditions characterized by cognitive limitations and difficulties with communication, social and practical skills. Examples are fetal alcohol syndrome, autism, down syndrome, and Fragile X syndrome.

Brown, supervised by WCRI scientist Dr. Simone Vigod, carried out the world’s largest study of childbirth to women with intellectual and developmental disabilities (IDD), analyzing about 4,000 births over a decade. She found that women with these disabilities are more likely to have serious pregnancy complications such as preeclampsia, blood clots, and hemorrhage, but their risks for gestational diabetes and gestational hypertension are similar to those for women without IDD. Their babies have increased risk for being born early and small for their gestational age. They also face a greater likelihood of stillbirth or death within one month.

The issue is of growing concern as childbirth rates increase in this group, Brown says. “A lot of people assume that these women don’t have babies because for decades they lived in large scale institutions and they were sterilized,” she says. A previous study found there are up to 450 such births per year in Ontario. Women with IDD under 25 years are having children almost as often as women in the same age group without IDD.

Researchers are still untangling why women with intellectual and developmental disabilities have more problems during and after pregnancy, but there are some indications. They are more likely to be socially isolated, live below the poverty line, and have higher rates of chronic disease, including diabetes and mental illness. They might not recognize the signs of complications during pregnancy or understand complex medical advice.

“These are very invisible disabilities,” Brown says. Anecdotal reports from case workers suggest that women might be afraid to reveal their disability to healthcare providers. Brown says we need more efforts to improve the health of women with IDD before they get pregnant and better monitor for complications before and after they give birth.

The study, published in the British Journal of Obstetrics and Gynaecology, used data from the Institute for Clinical Evaluative Sciences.

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