Time trends in births and cesarean deliveries among women with disabilities

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6 Citations (Scopus)

Abstract

Background: Although it is likely that childbearing among women with disabilities is increasing, no empirical data have been published on changes over time in the numbers of women with disabilities giving birth. Further, while it is known that women with disabilities are at increased risk of cesarean delivery, temporal trends in cesarean deliveries among women with disabilities have not been examined. Objective: To assess time trends in births by any mode and in primary cesarean deliveries among women with physical, sensory, or intellectual/developmental disabilities. Methods: We conducted a retrospective cohort study using linked vital records and hospital discharge data from all deliveries in California, 2000-2010 (n = 4,605,061). We identified women with potential disabilities using ICD-9 codes. We used descriptive statistics and visualizations to examine time patterns. Logistic regression analyses assessed the association between disability and primary cesarean delivery, stratified by year. Results: Among all women giving birth, the proportion with a disability increased from 0.27% in 2000 to 0.80% in 2010. Women with disabilities had significantly elevated odds of primary cesarean delivery in each year, but the magnitude of the odds ratio decreased over time from 2.60 (95% CI = 2.25 = 2.99) in 2000 to 1.66 (95% CI = 1.51-1.81) in 2010. Conclusion: Adequate clinician training is needed to address the perinatal care needs of the increasing numbers of women with disabilities giving birth. Continued efforts to understand cesarean delivery patterns and reasons for cesarean deliveries may help guide further reductions in proportions of cesarean deliveries among women with disabilities relative to women without disabilities.

Original languageEnglish (US)
JournalDisability and Health Journal
DOIs
StateAccepted/In press - Dec 5 2016

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Parturition
International Classification of Diseases
Perinatal Care
Developmental Disabilities
Hospital Records
Intellectual Disability
Cohort Studies
Retrospective Studies
Logistic Models
Odds Ratio
Regression Analysis

Keywords

  • Birth
  • Cesarean
  • Hospital discharge data
  • People with disabilities
  • Time trends

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Time trends in births and cesarean deliveries among women with disabilities",
abstract = "Background: Although it is likely that childbearing among women with disabilities is increasing, no empirical data have been published on changes over time in the numbers of women with disabilities giving birth. Further, while it is known that women with disabilities are at increased risk of cesarean delivery, temporal trends in cesarean deliveries among women with disabilities have not been examined. Objective: To assess time trends in births by any mode and in primary cesarean deliveries among women with physical, sensory, or intellectual/developmental disabilities. Methods: We conducted a retrospective cohort study using linked vital records and hospital discharge data from all deliveries in California, 2000-2010 (n = 4,605,061). We identified women with potential disabilities using ICD-9 codes. We used descriptive statistics and visualizations to examine time patterns. Logistic regression analyses assessed the association between disability and primary cesarean delivery, stratified by year. Results: Among all women giving birth, the proportion with a disability increased from 0.27{\%} in 2000 to 0.80{\%} in 2010. Women with disabilities had significantly elevated odds of primary cesarean delivery in each year, but the magnitude of the odds ratio decreased over time from 2.60 (95{\%} CI = 2.25 = 2.99) in 2000 to 1.66 (95{\%} CI = 1.51-1.81) in 2010. Conclusion: Adequate clinician training is needed to address the perinatal care needs of the increasing numbers of women with disabilities giving birth. Continued efforts to understand cesarean delivery patterns and reasons for cesarean deliveries may help guide further reductions in proportions of cesarean deliveries among women with disabilities relative to women without disabilities.",
keywords = "Birth, Cesarean, Hospital discharge data, People with disabilities, Time trends",
author = "Willi Horner-Johnson and Biel, {Frances M.} and Blair Darney and Aaron Caughey",
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language = "English (US)",
journal = "Disability and Health Journal",
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T1 - Time trends in births and cesarean deliveries among women with disabilities

AU - Horner-Johnson, Willi

AU - Biel, Frances M.

AU - Darney, Blair

AU - Caughey, Aaron

PY - 2016/12/5

Y1 - 2016/12/5

N2 - Background: Although it is likely that childbearing among women with disabilities is increasing, no empirical data have been published on changes over time in the numbers of women with disabilities giving birth. Further, while it is known that women with disabilities are at increased risk of cesarean delivery, temporal trends in cesarean deliveries among women with disabilities have not been examined. Objective: To assess time trends in births by any mode and in primary cesarean deliveries among women with physical, sensory, or intellectual/developmental disabilities. Methods: We conducted a retrospective cohort study using linked vital records and hospital discharge data from all deliveries in California, 2000-2010 (n = 4,605,061). We identified women with potential disabilities using ICD-9 codes. We used descriptive statistics and visualizations to examine time patterns. Logistic regression analyses assessed the association between disability and primary cesarean delivery, stratified by year. Results: Among all women giving birth, the proportion with a disability increased from 0.27% in 2000 to 0.80% in 2010. Women with disabilities had significantly elevated odds of primary cesarean delivery in each year, but the magnitude of the odds ratio decreased over time from 2.60 (95% CI = 2.25 = 2.99) in 2000 to 1.66 (95% CI = 1.51-1.81) in 2010. Conclusion: Adequate clinician training is needed to address the perinatal care needs of the increasing numbers of women with disabilities giving birth. Continued efforts to understand cesarean delivery patterns and reasons for cesarean deliveries may help guide further reductions in proportions of cesarean deliveries among women with disabilities relative to women without disabilities.

AB - Background: Although it is likely that childbearing among women with disabilities is increasing, no empirical data have been published on changes over time in the numbers of women with disabilities giving birth. Further, while it is known that women with disabilities are at increased risk of cesarean delivery, temporal trends in cesarean deliveries among women with disabilities have not been examined. Objective: To assess time trends in births by any mode and in primary cesarean deliveries among women with physical, sensory, or intellectual/developmental disabilities. Methods: We conducted a retrospective cohort study using linked vital records and hospital discharge data from all deliveries in California, 2000-2010 (n = 4,605,061). We identified women with potential disabilities using ICD-9 codes. We used descriptive statistics and visualizations to examine time patterns. Logistic regression analyses assessed the association between disability and primary cesarean delivery, stratified by year. Results: Among all women giving birth, the proportion with a disability increased from 0.27% in 2000 to 0.80% in 2010. Women with disabilities had significantly elevated odds of primary cesarean delivery in each year, but the magnitude of the odds ratio decreased over time from 2.60 (95% CI = 2.25 = 2.99) in 2000 to 1.66 (95% CI = 1.51-1.81) in 2010. Conclusion: Adequate clinician training is needed to address the perinatal care needs of the increasing numbers of women with disabilities giving birth. Continued efforts to understand cesarean delivery patterns and reasons for cesarean deliveries may help guide further reductions in proportions of cesarean deliveries among women with disabilities relative to women without disabilities.

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