title: Disparities in Adverse Preconception Risk Factors Between Women with and Without Disabilities.
abstract: OBJECTIVE
  The objective of this study was to compare the prevalence of select preconception health indicators among women with and without disabilities.
  
  
  METHODS
  2010 Behavioral Risk Factor Surveillance System data were used to estimate the prevalence of health behaviors, health status indicators, and preventive health care among non-pregnant women ages 18-44 years with (N = 8370) and without (N = 48,036) disabilities. Crude percentages were compared with Chi square statistics. Multivariable logistic regressions adjusted for socio-demographic factors.
  
  
  RESULTS
  Women with disabilities were more likely than women without disabilities to currently smoke (30.5 vs. 14.5 %, p < 0.0001) and less likely to exercise in the past month (67.1 vs. 79.8 %, p < 0.0001). Heavy drinking was similar in the two groups (4.4 vs. 4.5 %, p = 0.9). Health status indicators were worse among women with disabilities, with 35.0 % reporting fair/poor health and 12.4 % reporting diabetes, compared with 6.7 and 5.6 %, respectively, among women with no disabilities (p < 0.0001 for both). Frequent mental distress, obesity, asthma, and lack of emotional support were also higher among women with disabilities compared with their non-disabled counterparts. Women with disabilities were more likely to receive some types of preventive care, (HIV), but less likely to receive others (recent dental cleaning, routine checkup). Disparities in health behaviors and health status indicators between the two groups remained after adjusting for socio-demographic factors.
  
  
  CONCLUSIONS
  Women with disabilities at reproductive age are more vulnerable to risk factors associated with adverse pregnancy outcomes compared to their counterparts without disabilities. Our findings highlight the need for preconception health care for women with disabilities.
authors.affiliation: Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA, 01545, USA. monika.mitra@umassmed.edu.
authors.forename: Monika
authors.initials: M
authors.lastname: Mitra
authors.affiliation: Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA, 01545, USA. karen.clements@umassmed.edu.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Clements
authors.affiliation: Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA, 01545, USA. Jianying.zhang@umassmed.edu.
authors.forename: Jianying
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA, 01545, USA. lauren.smith@umassmed.edu.
authors.forename: Lauren D
authors.initials: LD
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D040343:Behavioral Risk Factor Surveillance System; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006305:Health Status Indicators; D006801:Humans; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D011159:Population Surveillance; D016742:Preconception Care; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Preconception health; Pregnancy; Prenatal care; Women with disabilities