Perinatal & Pediatric
The Association of Maternal Intellectual and Developmental Disabilities with Adverse Birth and Infant Outcomes in California Catherine Psaras* Catherine Psaras Gretchen Bandoli Rita Ryu
Background. Intellectual and developmental disabilities (IDD) involve cognitive and adaptive deficits beginning before age 18–22. While fertility rates among individuals with IDD are rising alongside recognition of their reproductive rights, they still face significant social, healthcare, and health disparities during pregnancy. This study aimed to examine the relationship between IDD subtypes and adverse birth and infant outcomes. Methods. This population-based study analyzed linked data from California (2007–2021), including birth, infant death, discharge, emergency department, and ambulatory surgery center records. We compared singleton births to women with preexisting IDD (autism (ASD), cerebral palsy (CP), intellectual disability (ID), chromosomal abnormalities, and other IDD) to those without, using ICD codes to identify disabilities. The primary outcomes were NICU admission, small for gestational age (SGA), and very pre-term birth (PTB). Relative risks were adjusted for maternal age at birth. Results. The data included 6,430,534 singleton infants born from 2007–2021. 4,713 infants born among women with IDD (non-mutually exclusive subtypes: ASD: 458; CP: 1019; ID: 1817; chromosomal abnormalities: 1571; other IDD: 600). All five IDD subtypes were associated with increased risks for adverse infant outcomes. The strongest associations were observed in infants born to mothers with intellectual disabilities (RR [95% CI]: NICU: 3.12 [2.74, 3.56]; SGA: 1.86 [1.63, 2.13]; PTB: 2.87 [2.05, 4.01]) and chromosomal abnormalities (RR [95% CI]: NICU: 3.21 [2.87, 3.59]; SGA: 1.65 [1.47, 1.86]; PTB: 4.07 [3.07, 6.50]). Discussion. Women with IDD face significantly higher risks of adverse birth and infant outcomes. Given the increasing fertility rates in this population, further research is essential to develop strategies to prevent these outcomes and address associated disparities.