TY - JOUR
T1 - Prolonged postpartum length of hospital stay among women with disabilities
AU - Horner-Johnson, Willi
AU - Darney, Blair G.
AU - Biel, Frances M.
AU - Caughey, Aaron B.
N1 - Funding Information:
Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under award # R21HD081309 (Horner-Johnson, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funding agency had no role in the conduct of the research or preparation of the manuscript for submission.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/10
Y1 - 2020/10
N2 - Background: Prior studies have found higher proportions of cesarean deliveries and longer postpartum hospital stays among women with disabilities compared to women without disabilities. However, no research has assessed how length of stay may differ for women with different types of disability while also considering mode of delivery. Objective: To examine the association of disability status and disability type with length of stay, taking into account disability-related differences in mode of delivery. Methods: We conducted a retrospective cohort study using linked maternal and infant hospital discharge and vital records data for all births in California between 2000 and 2012 (n = 6,745,201). We used multivariable regression analyses to assess association of disability status and type with prolonged length of stay (>2 days for vaginal delivery or >4 days for cesarean) while controlling for covariates. Results: Women with disabilities had significantly elevated adjusted odds of prolonged length of stay compared to women without disabilities (aOR = 1.40, 95% CI = 1.32–1.49). Adjusted odds were highest for women with vision disabilities (aOR = 1.67, 95% CI = 1.46–1.90), followed by women with IDD (aOR = 1.53, 95% CI = 1.30–1.80), and women with physical disabilities (aOR = 1.41, 95% CI = 1.32–1.50). Women with hearing disability had the lowest adjusted odds of prolonged length of stay (aOR = 1.17, 95% CI = 1.03–1.33). Conclusions: Prolonged length of stay did not appear to be due solely to the higher proportion of cesarean deliveries in this population. Further research is needed to better understand the reasons for prolonged length of stay among women with disabilities and develop strategies to assist women with disabilities in preparing for and recovering from childbirth.
AB - Background: Prior studies have found higher proportions of cesarean deliveries and longer postpartum hospital stays among women with disabilities compared to women without disabilities. However, no research has assessed how length of stay may differ for women with different types of disability while also considering mode of delivery. Objective: To examine the association of disability status and disability type with length of stay, taking into account disability-related differences in mode of delivery. Methods: We conducted a retrospective cohort study using linked maternal and infant hospital discharge and vital records data for all births in California between 2000 and 2012 (n = 6,745,201). We used multivariable regression analyses to assess association of disability status and type with prolonged length of stay (>2 days for vaginal delivery or >4 days for cesarean) while controlling for covariates. Results: Women with disabilities had significantly elevated adjusted odds of prolonged length of stay compared to women without disabilities (aOR = 1.40, 95% CI = 1.32–1.49). Adjusted odds were highest for women with vision disabilities (aOR = 1.67, 95% CI = 1.46–1.90), followed by women with IDD (aOR = 1.53, 95% CI = 1.30–1.80), and women with physical disabilities (aOR = 1.41, 95% CI = 1.32–1.50). Women with hearing disability had the lowest adjusted odds of prolonged length of stay (aOR = 1.17, 95% CI = 1.03–1.33). Conclusions: Prolonged length of stay did not appear to be due solely to the higher proportion of cesarean deliveries in this population. Further research is needed to better understand the reasons for prolonged length of stay among women with disabilities and develop strategies to assist women with disabilities in preparing for and recovering from childbirth.
KW - Length of stay
KW - Persons with disabilities
KW - Postpartum period
KW - Women's health
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U2 - 10.1016/j.dhjo.2020.100934
DO - 10.1016/j.dhjo.2020.100934
M3 - Article
C2 - 32402792
AN - SCOPUS:85084389794
VL - 13
JO - Disability and Health Journal
JF - Disability and Health Journal
SN - 1936-6574
IS - 4
M1 - 100934
ER -