Health of Newborns and Infants Born to Women With Disabilities: A Meta-analysis

Abstract

CONTEXT: Women with disabilities are at elevated risk for pregnancy, delivery, and postpartum complications. However, there has not been a synthesis of literature on the neonatal and infant health outcomes of their offspring. OBJECTIVE: We examined the association between maternal disability and risk for adverse neonatal and infant health outcomes. DATA SOURCES: Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, and PsycINFO were searched from database inception to January 2020. STUDY SELECTION: Studies were included if they reported original data on the association between maternal physical, sensory, or intellectual and/or developmental disabilities and neonatal or infant health outcomes; had a referent group of women with no disabilities; were peer-reviewed journal articles or theses; and were written in English. DATA EXTRACTION: We used standardized instruments to extract data and assess study quality. DerSimonian and Laird random effects models were used for pooled analyses. RESULTS: Thirty-one studies, representing 20 distinct cohorts, met our inclusion criteria. Meta-analyses revealed that newborns of women with physical, sensory, and intellectual and/or developmental disabilities were at elevated risk for low birth weight and preterm birth, with smaller numbers of studies revealing elevated risk for other adverse neonatal and infant outcomes. LIMITATIONS: Most studies had moderate (n = 9) or weak quality (n = 17), with lack of control for confounding a common limitation. CONCLUSIONS: In future work, researchers should explore the roles of tailored preconception and perinatal care, along with family-centered pediatric care particularly in the newborn period, in mitigating adverse outcomes among offspring of women with disabilities.