Pregnancy in women with congenital physical disabilities: Risk factors, birth outcomes, and mediation

先天性身体残疾妇女的怀孕：危险因素、出生结局和调解

• 批准号: 9883035
• 负责人: MARTHA M. WERLER
• 金额: $ 8.25万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9883035
• 关键词: Activities of Daily Living; Address; Affect; Alcohol consumption; Analgesics; Behavioral; Birth; Birth Weight; Birthing Centers; Body mass index; Boston; Brain; Caring; Cerebral Palsy; Characteristics; Child; Congenital Abnormality; Contracture; Data; Defect; Demographic Factors; Ensure; Epidemiology; Event; Family; Female of child bearing age; Fertility; General Population; Gestational Age; Head; Impairment; Individual; Infective cystitis; Interview; Kidney; Leg; Limb structure; Longevity; Low Birth Weight Infant; Measures; Mediating; Mediation; Mothers; Muscle; Muscular Dystrophies; National Institute of Child Health and Human Development; Obesity; Outcome; Pharmaceutical Preparations; Population; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Prevention; Reporting; Reproductive History; Research; Risk; Risk Factors; Services; Site; Sleep; Sleep disturbances; Spinal Cord; Spinal Dysraphism; Supplementation; Universities; Vertebral column; Vitamins; Weight; Woman; adverse birth outcomes; adverse outcome; arm; base; bone; chronic pain; cigarette smoking; congenital anomaly; coping mechanism; data resource; dexterity; disability; improved; neuromuscular; physically handicapped; premature; prepregnancy; psychosocial; reproductive; response; stem; symptom treatment; women with disabilities

The average lifespan of individuals born with most congenital malformations has vastly improved in the past decades, allowing the majority to survive through the reproductive years. Because the presence of a physical disability typically does not affect fertility or the desire for a family, it is important to understand the course of pregnancy among affected women. Evidence shows that women with varying definitions of disability are more likely to have babies born with low birth weights or prematurely. The limited research available suggests that relevant risk factors for these birth outcomes tend to be more common in pregnant women with varying disabilities compare to the general population. For example, cigarette smoking, alcohol drinking, and obesity increase risks of adverse outcomes and appear to be disproportionately higher in pregnant women with disabilities. However no study to date has examined pregnancy exposures in relation to adverse birth outcomes among women with physical disabilities. In women of childbearing ages, physical disabilities most often stem from congenital muscular and neuromuscular defects (cMND), defined as spina bifida, cerebral palsy, muscular dystrophy, and limb anomalies (contractures, missing or shortened). Impairments in mobility and dexterity can impact activities of daily living and result in chronic pain, sleep disturbances, and psychosocial problems. Medications needed for the treatment of these symptoms, and other behavioral coping mechanisms, may be associated with birth outcomes, raising further the need to study the course of pregnancy and birth outcomes among cMND-affected women. This study will take advantage of rich data resource - the Boston University Slone Epidemiology Center Birth Defects Study. From 1976 to 2015, over 68,000 mothers of babies born with and without congenital anomalies were asked detailed questions about a range of events and exposures during pregnancy for the purpose of identifying risk factors for birth defects. Women were specifically asked if they were born with spina bifida or any anomalies of the brain, head, spine, spinal cord, muscles, bones, arms, or legs. This study will compare the 132 women who were identified as having a cMND to 528 unaffected women for the following pregnancy exposures: cigarette smoking, alcohol intake, pre- pregnancy body mass index, vitamin supplementation, kidney/bladder infection, pain medications, sleep medications, and psychoactive medications. Comparisons of common adverse birth outcomes will include premature birth, low birth weight, and macrosomia. In addition, mediation analyses will measure the amount of an association between cMND and birth outcomes that is mediated through pregnancy exposures. An estimated 212,000 US women of childbearing ages have a cMND, for whom pregnancy may require special services. It is necessary to understand the course of pregnancy and outcomes among women with congenital physical disabilities as a step toward ensuring optimal care and risk prevention. This project takes advantage of a unique data resource to provide valuable information for this purpose.

在过去，患有大多数先天性畸形的人的平均寿命大大延长了

项目成果

Birth outcomes among women with congenital neuromuscular disabilities.

• DOI: 10.1016/j.dhjo.2021.101259
• 发表时间: 2022-04
• 期刊: Disability and health journal
• 影响因子: 4.5
• 作者: Huezo García M;Parker SE;Petersen JM;Rubenstein E;Werler MM
• 通讯作者: Werler MM

Medication use during pregnancy among women with congenital physical disabilities.

• DOI: 10.1002/bdr2.2048
• 发表时间: 2022-08-15
• 期刊: BIRTH DEFECTS RESEARCH
• 影响因子: 2.1
• 作者: Garcia, Michelle Huezo;Petersen, Julie M.;Parker, Samantha E.;Rubenstein, Eric;Werler, Martha M.
• 通讯作者: Werler, Martha M.