Pregnancy Characteristics and Outcomes among Women at Risk for Disability from Health Conditions Identified in Medical Claims
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UMass Chan Affiliations
Department of Quantitative Health SciencesCommonwealth Medicine, Center for Health Policy and Research
Document Type
Journal ArticlePublication Date
2016-09-01Keywords
disabilitiespregnancy
infant and maternal outcomes
Clinical Epidemiology
Epidemiology
Female Urogenital Diseases and Pregnancy Complications
Health Services Administration
Health Services Research
Maternal and Child Health
Obstetrics and Gynecology
Women's Health
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BACKGROUND: Women with disabilities are at risk for poor birth outcomes. Little is known about specific potentially disabling health conditions and their effects on pregnancies. Using hospital claims, we identified women at risk for disability and evaluated the relationship between disability risk and demographic characteristics, pregnancy risks, and infant and maternal outcomes. METHODS: The 2006 through 2009 Massachusetts Pregnancy to Early Life Longitudinal data system linked birth certificate and hospital claims one year pre-pregnancy through delivery. Access Risk Classification System categorized International Classification of Diseases, Ninth Revision, Clinical Modification/Current Procedural Terminology codes into disability risk groups (no/limited vs. medium/high). Generalized estimating equations evaluated the association between disability risk and infant and maternal outcomes. RESULTS: Of 221,867 women, 14,701 (6.6%) were at medium or high risk of disability. Health conditions were classified as circulatory (23%), musculoskeletal (10%), nervous system/sensory (13%), other physical (19%), two or more physical (5%), mental illness (24%), and comorbid mental/physical (6%). Women at risk of disability were more likely than others to have socioeconomic and pregnancy risks, and adverse infant and maternal outcomes. Socioeconomic and risk profile varied by health condition category. Adjusted risk ratios for preterm birth ranged from 1.2 (95% confidence interval [CI], 1.1-1.4) for women with nervous system/sensory diagnoses to 1.6 (95% CI, 1.4-1.9) for women with two or more physical diagnoses; risk ratios for maternal delivery hospitalization for more than 5 days ranged from 1.5 (95% CI, 1.2-1.9) for women with musculoskeletal diagnoses to 3.0 (95% CI, 2.5-3.6) for women with comorbid mental/physical diagnoses. CONCLUSIONS: Disability risk identified through claims is associated with poor infant and maternal outcomes. Risk profiles vary by underlying health condition.Source
Womens Health Issues. 2016 Sep-Oct;26(5):504-10. doi: 10.1016/j.whi.2016.06.001. Epub 2016 Jul 28. Link to article on publisher's siteDOI
10.1016/j.whi.2016.06.001Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27054PubMed ID
27477954Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.whi.2016.06.001
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