Women with intellectual and developmental disabilities have nearly double the rate of rapid repeat pregnancy: Study

The study, published in CMAJ, found that among women with intellectual and developmental disabilities who became pregnant, 7.6 per cent had another baby within a year, compared to a 3.9 per cent chance for women without these disabilities.

Rapid repeat pregnancy within 12 months of a live birth is associated with poor pregnancy outcomes, such as stillbirth and preterm delivery, and is also an indication of suboptimal access to effective reproductive health care, including contraception.

“Women with intellectual and developmental disabilities are more likely than those without such disabilities to be young and disadvantaged in each marker of social, health, and healthcare disparities. They experience high rates of poverty and chronic physical and mental illness, and have poor access to primary care,” says Hilary Brown, an adjunct scientist at ICES and lead author of the study.

Intellectual and developmental disabilities affect one in 100 adults and are characterized by cognitive limitations and problems with social and practical skills. Some diagnoses include Down syndrome, fetal alcohol syndrome, and autism, but many people with intellectual and developmental disabilities have non-specific diagnoses with unknown causes.

The researchers evaluated the risk for a rapid repeat pregnancy within 12 months of a live birth in 2,855 women with and 923,367 women without intellectual and developmental disabilities, before and after accounting for demographic, social, health, and health care factors that could explain differences between the two groups.

The researchers found that the difference in risk remained elevated after taking demographics into account. The social, health, and health care disparities experienced by women with intellectual and developmental disabilities explains this difference in risk, illustrating that approaches that address marginalization in this population of women are needed to improve their reproductive health.

“This study shows that current efforts to promote reproductive health might not be reaching women with intellectual and developmental disabilities and that there is a lot more we can do to educate and support these women in relation to pregnancy planning and contraception,” adds Brown.