title: Maternal and offspring outcomes in women with intellectual and developmental disabilities: a population-based cohort study.
abstract: OBJECTIVE
  To compare the risks for adverse maternal and offspring outcomes in women with and without intellectual and developmental disabilities.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  Ontario, Canada.
  
  
  METHODS
  Singleton obstetrical deliveries to 18- to 49-year-old women with and without intellectual and developmental disabilities (n = 3932 in the exposed cohort, n = 382 774 in the unexposed cohort; 2002-2011 fiscal years).
  
  
  METHODS
  Women with intellectual and developmental disabilities were identified based on diagnoses in health administrative data or receipt of disability income support. The unexposed cohort comprised women without intellectual and developmental disabilities. Modified Poisson regression was used to compute adjusted relative risks (aRR) and 95% confidence intervals (CI) comparing the two cohorts.
  
  
  METHODS
  Primary maternal outcomes were: gestational diabetes, gestational hypertension, pre-eclampsia, eclampsia, and venous thromboembolism. Primary offspring outcomes were: preterm birth, small for gestational age, and large for gestational age.
  
  
  RESULTS
  The exposed cohort, compared with the unexposed cohort, had increased risks for pre-eclampsia (aRR 1.47, 95% CI 1.11-1.93) and venous thromboembolism (aRR 1.60, 95% CI 1.17-2.19). Their offspring had increased risks for preterm birth (aRR 1.63, 95% CI 1.47-1.80) and small for gestational age (aRR 1.35, 95% CI 1.25-1.45).
  
  
  CONCLUSIONS
  These findings suggest that there is a need to address modifiable risk factors for adverse outcomes among women with intellectual and developmental disabilities prior to and during pregnancy. Moreover, there is a need to enhance monitoring for maternal and offspring complications in this population.
  
  
  CONCLUSIONS
  Large cohort study: intellectual and developmental disabilities predispose women/babies to adverse outcomes.
authors.affiliation: Women's College Research Institute and University of Toronto, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: H K
authors.initials: HK
authors.lastname: Brown
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.|School of Psychology, University of Ottawa, Ottawa, ON, Canada.
authors.forename: V
authors.initials: V
authors.lastname: Cobigo
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.|Centre for Addiction and Mental Health and University of Toronto, Toronto, ON, Canada.
authors.forename: Y
authors.initials: Y
authors.lastname: Lunsky
authors.affiliation: Women's College Research Institute and University of Toronto, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: S N
authors.initials: SN
authors.lastname: Vigod
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000150:complications*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012307:Risk Factors; D055815:Young Adult
keywords: Developmental disabilities; intellectual disability; pre-eclampsia; preterm birth; small for gestational age; venous thromboembolism