title: Pregnancy in Women With Intellectual and Developmental Disabilities.
abstract: OBJECTIVE
  Our objectives were to describe the general fertility rate (GFR) and age-specific fertility rates (ASFRs) of women with intellectual and developmental disabilities (IDD) and the social and health characteristics of those with a singleton live birth, and to compare these to women without IDD.
  
  
  METHODS
  In this population-based retrospective cohort study using linked Ontario health and social services administrative data, we identified 18- to 49-year-old women with IDD (N = 21 181) and without IDD (N = 990 776). The GFR and ASFRs (2009) were calculated for both groups and compared using rate ratios (RR) and 95% confidence intervals (CI). Among women with a singleton live birth (N = 423 with, N = 42 439 without IDD), social and health characteristics were compared using Pearson's Chi square tests.
  
  
  RESULTS
  The GFR in women with IDD (20.3 per 1000) was lower than that in women without IDD (43.4 per 1000) (RR 0.47; 95% CI 0.43 to 0.51). ASFRs in 18- to 24-year-olds were similar in both groups. Among women with a singleton live birth, those with IDD were younger and had higher rates of poverty, epilepsy, obesity, and mental health issues. They also had high rates of medication use during pregnancy.
  
  
  CONCLUSIONS
  In the largest study of fertility in women with IDD to date, we found that ASFRs are similar in young women with and without IDD. Women with IDD with a singleton live birth experience significant social and health disparities during pregnancy. These findings suggest the need to develop services to support the reproductive health of this vulnerable group.
authors.affiliation: Women's College Research Institute, Women's College Hospital, Toronto, Ontario; Institute for Clinical Evaluative Sciences, Toronto, Ontario; Department of Psychiatry, University of Toronto, Toronto, Ontario.
authors.forename: Hilary K
authors.initials: HK
authors.lastname: Brown
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario; Department of Psychiatry, University of Toronto, Toronto, Ontario; Centre for Addiction and Mental Health, Toronto, Ontario.
authors.forename: Yona
authors.initials: Y
authors.lastname: Lunsky
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Wilton
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario; School of Psychology, University of Ottawa, Ottawa, Ontario.
authors.forename: Virginie
authors.initials: V
authors.lastname: Cobigo
authors.affiliation: Women's College Research Institute, Women's College Hospital, Toronto, Ontario; Institute for Clinical Evaluative Sciences, Toronto, Ontario; Department of Psychiatry, University of Toronto, Toronto, Ontario.
authors.forename: Simone N
authors.initials: SN
authors.lastname: Vigod
mesh_terms: D000293:Adolescent; D000328:Adult; D001723:Birth Rate; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D066252:Sociological Factors
keywords: Birth; Birth rate; Developmental disability; Fertility rate; Intellectual disability