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Assessing Neonatal Outcomes of Mothers With a Disability

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If a mother with a disability is pregnant asks for counseling about whether she should be concerned about risk in her baby, what would you say?  Brown et al (10.1542/peds.2021-055318) share with us a population-based cohort study involving all singleton livebirths in Ontario, Canada (2003-2018), including more than 144,000 mothers with a physical disability, 44,900 with a sensory disability, 2,200 with an intellectual or developmental disability, and more than 8,800 with 2 or more disabilities. Outcome measures in this study included preterm birth, small or large for gestational age births, neonatal morbidity and mortality ≤28 days after birth, neonatal abstinence syndrome, and NICU admission. 

This study found a mildly to moderately increased risk for complications of newborns born to mothers with an intellectual/developmental disability and to mothers with 2 or more disabilities. What do we with this data to reduce the risk of a poor outcome to infants of mothers with disabilities? To answer that we solicited a commentary (10.1542/peds.2022-058043) from Drs. Kathleen Hannan, Sunah Hwang, and Stephanie Bourque in the Neonatology Division at the University of Colorado School of Medicine. They note the uniqueness of this data in this understudied area and highlight the need to pay attention to the impact of maternal disabilities needs and other perinatal risk factors. The commentary provides examples of next steps, which includes testing interventions to prevent poor birth outcomes in the infants born to mothers with a disability. Link to this study and consider sharing the findings with parents in your practice who are disabled and pregnant.

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