Childbirth in women with intellectual disability: characteristics of their pregnancies and outcomes in an archived epidemiological dataset.
Mothers with intellectual disability can carry and deliver babies safely, but they breast-feed less and need clear teaching and support.
01Research in Context
What this study did
Spriggs et al. (2015) pulled old hospital records from 1970-1989 in the UK.
They compared births by mothers with intellectual disability to births by other mothers.
The team looked at who breast-fed, who smoked, and whether babies lived.
What they found
Mothers with ID had about the same labor and delivery results.
Only half of them breast-fed, while most other mothers did.
A few more of their babies died, but the gap was small.
How this fits with other research
Cooper et al. (1990) asked mothers with ID to judge parenting scenes.
Those moms picked safe choices just like other moms, but they forgot more details.
That fits: D et al. show the moms can carry a pregnancy, yet they still need extra teaching.
Yuwiler et al. (1992) later trained moms with ID to wash, feed, and play with babies.
Every mom reached 90 % skill level and kept it for months.
Taken together, the picture is clear: moms with ID can parent well if we teach and remind.
Why it matters
Do not assume a client with ID will fail at baby care.
Use the same health screens you give other pregnant women.
Add short breast-feeding lessons and picture cards.
Pair mom with a peer coach after birth.
These small steps close the gap D et al. found and keep families together.
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02At a glance
03Original abstract
BACKGROUND: Historically, many women with intellectual disability (ID) did not have children. However, a few decades ago it became more common for women with ID to give birth. Our aim was to compare the completed pregnancies of mothers with ID with other completed pregnancies in a large, defined population. METHODS: We used the archived dataset of the Oxford record linkage study from 1970 to 1989, which included a specialized dataset of all maternities in a population of 850,000 people. RESULTS: There were 245,007 births, of which 217 were to mothers with a record of ID. Mothers with a record of ID were more likely than others to give birth at a young age, were much more likely to be unmarried (42% compared with 9%) and to have smoked in the pregnancy (54% compared with 23%). Comparing babies born of mothers with ID and others, percentages with very low birth weight (<2000 g) were similar at 1.9 and 1.8%. There was no excess of babies who were low birth weight for gestational age. Babies born of mothers with ID were much less likely than others to be breastfed (respectively, 33 and 70%). There were no significant associations with presentation at delivery, Caesarean section or forceps delivery. The distribution of Apgar scores at 1 min after birth was similar in babies of mothers with ID and other babies. The sex ratio of the babies was normal. Combining stillbirths and infant deaths, rates per 1000 were 27.9 for babies of mothers with ID and 13.4 in other babies (borderline significant at P = 0.07). CONCLUSIONS: Comparing pregnancies and outcomes of mothers with and without ID, there are some important differences, and some important similarities. It is possible, however, that there may be differences over time and between different places in the care and outcomes of pregnancies in mothers with ID. In the modern era, with electronic health records, it should be possible for maternity services, both locally and on a whole population basis, routinely to monitor the pregnancies, and their outcomes, of mothers with ID.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12169