Pregnancy rates, risk factors, and child and mother outcomes for women with intellectual and developmental disabilities in Wisconsin.

项目摘要 超过220万美国成年人患有智力或发育障碍（IDD）， 经济地位、健康和教育。在过去的二十年里，越来越多的年轻人携带IDD 诊断（3-17岁儿童的5.8%，自1999年以来增加了35%）。当这个种群进入繁殖期， 在此期间，个人，家庭和研究人员对怀孕期间的健康表示担忧， 为患有缺碘症的妇女及其子女提供育儿服务。重要的是要了解目前的比例， 怀孕;不良怀孕结果的风险因素;以及由此产生的孕产妇和儿童发育 结果和家庭服务使用情况，以便为缺碘症患者提供充分服务， 为将来更多的群体行使其生殖权利。我们的目标是建立基础知识 改善妊娠结果和制定支持患有碘缺乏病的父母的方案是必要的。在R 03中，我们 我建议利用大数据4小孩子（BD 4LK）项目，该项目将威斯康星州的全民医疗补助联系起来 2007-2016年（260 000奈良）至一年孕前医疗补助申请，产后孕产妇 索赔和卫生服务利用，以及儿童健康结果和卫生服务利用。医疗补助是领先的 威斯康星州缺碘症患者保健服务提供者;6然而，这些数据未充分用于检查 生殖和妊娠相关健康成果服务的使用。我们的三个目标是：（1）估计 活产婴儿的比例，并在我们的BD 4LK中计算IDD妇女的年龄别生育率和总生育率 （2）评估患有碘缺乏病的孕妇是否处于 与未患缺碘症的孕妇相比，孕妇怀孕或与儿童有关的并发症的风险更大 并调查潜在的途径;（3）描述患有IDD的母亲的妊娠后结局， 他们的孩子包括健康结果和卫生服务的吸收，并与母亲的结果进行比较 没有IDD。这种方法是创新的，因为它使用了这一独特的数据集，方法上合理的方法， 以及在研究过程中与缺碘症妇女的互动。我们的研究结果将帮助服务提供商更好地 为育龄妇女及其家人提供服务。结果还将帮助我们确定特定领域 用于医疗和行为干预。随着年龄和生殖健康状况的改善， 7 -10这项赠款将提供初步数据， 需要资源来支持进一步的数据联系，以评估社会服务的使用情况。此外，这项工作将 支持我们的目标，即建立一个有前景的缺碘症妇女及其家庭纵向队列， 利用研究成果和服务使用情况，并制定有效的干预措施，以改善健康和质量 这是越来越多的缺碘症父母及其子女生活的一部分。

Project abstract Over 2.2 million US adults have an intellectual or developmental disability (IDD), and experience disparities in economic standing, health, and education. In the past twenty years, more young people are carrying IDD diagnoses (5.8% of children age 3-17, 35% increase since 1999). As this population enters the reproductive period, individuals, families, and researchers have raised concern about wellbeing during pregnancy and parenthood for women with IDD and their children. It is vital to understand the current proportion of pregnancies; risk factors for poor pregnancy outcomes; and resulting maternal and child developmental outcomes and familial service use in women with IDD to adequately serve the population with IDD and prepare for future, larger cohorts exercising their reproductive rights. We aim to build the foundational knowledge necessary to improve pregnancy outcomes and develop programs to support parents with IDD. In this R03, we propose to leverage the Big Data 4 Little Kids (BD4LK) project which links Wisconsin State Medicaid for all pregnancies from 2007-2016 (N≈260 000) to one-year prepregnancy Medicaid claims, post-partum maternal claims and health service use, and child health outcomes and health service use. Medicaid is the leading health service provider for people with IDD in Wisconsin;6 yet, these data are underutilized to examine reproductive and pregnancy related health outcomes service use. Our three aims are to: (1) Estimate proportion of live births, and calculate age specific and total fertility rate in women with IDD in our BD4LK sample, comparing results to mothers without IDD; (2) Evaluate whether pregnant women with IDD are at greater risk for maternal pregnancy or child related complications compared to pregnant women without IDD and investigate potential pathways; and (3) Characterize post-pregnancy outcomes for mothers with IDD and their children including health outcomes and health service uptake and compare with outcomes for mothers without IDD. This approach is innovative for its use of this unique data set, methodologically sound approach, and interaction with women with IDD in the research process. Our results will help service providers better serve women with IDD of reproductive age and their families. Results will also help us identify specific areas for medical and behavioral intervention. As larger cohorts of individuals with IDD age and their reproductive rights are recognized, we will see more parents with IDD.7-10 This grant will provide the preliminary data and resources needed to support further data linkages to assess social service use. Additionally, this work will support our aim to build a prospective longitudinal cohort of women with IDD and their families that can be leveraged to study outcomes and service use and develop effective interventions to improve health and quality of life for this growing population of parents with IDD and their children.