title: Pregnancy among US women: differences by presence, type, and complexity of disability.
abstract: BACKGROUND
  Approximately 12% of women of reproductive age have some type of disability. Very little is known about sexual and reproductive health issues among women with disabilities, including what proportion of women with disabilities experience pregnancy. Data on pregnancy are important to inform needs for preconception and pregnancy care for women with disabilities.
  
  
  OBJECTIVE
  The purpose of this study was to describe the occurrence of pregnancy among women with various types of disability and with differing levels of disability complexity, compared with women without disabilities, in a nationally representative sample.
  
  
  METHODS
  We conducted cross-sectional analyses of 2008-2012 Medical Expenditure Panel Survey annualized data to estimate the proportion of women aged 18-44 years with and without disabilities who reported a pregnancy during 1 year of participation on the survey panel. We used a multivariable logistic regression to test the association of pregnancy with presence, type, and complexity of disability, controlling for other factors associated with pregnancy.
  
  
  RESULTS
  Similar proportions of women with and without disabilities reported a pregnancy (10.8% vs 12.3%, with 95% confidence intervals overlapping). Women with the most complex disabilities (those that impact activities such as self-care and work) were less likely to have been pregnant (adjusted odds ratio, 0.69, 95% confidence interval, 0.52-0.93), but women whose disabilities affected only basic actions (seeing, hearing, movement, cognition) did not differ significantly from women with no disabilities.
  
  
  CONCLUSIONS
  Women with a variety of types of disabilities experience pregnancy. Greater attention is needed to the reproductive health care needs of this population to ensure appropriate contraceptive, preconception, and perinatal care.
authors.affiliation: Institute on Development and Disability, Oregon Health and Science University, Portland, OR. Electronic address: hornerjo@ohsu.edu.
authors.forename: Willi
authors.initials: W
authors.lastname: Horner-Johnson
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR; National Institute of Public Health, Center for Health Systems Research, Cuernavaca, Mexico.
authors.forename: Blair G
authors.initials: BG
authors.lastname: Darney
authors.affiliation: Institute on Development and Disability, Oregon Health and Science University, Portland, OR.
authors.forename: Sheetal
authors.initials: S
authors.lastname: Kulkarni-Rajasekhara
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR.
authors.forename: Brian
authors.initials: B
authors.lastname: Quigley
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR.
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D015999:Multivariate Analysis; D011247:Pregnancy; D018873:Pregnancy Rate; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: people with disabilities; population-based data; pregnancy; women