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  4. Pregnancy outcomes in women with spinal cord injuries: a population-based study

Pregnancy outcomes in women with spinal cord injuries: a population-based study

PM R, 2019 · DOI: 10.1002/pmrj.12122 · Published: August 1, 2019

Spinal Cord InjuryWomen's Health

Simple Explanation

This study looked at pregnancy outcomes for women with spinal cord injuries, paralysis, or spina bifida using data from Washington State. The researchers compared these women to a group of women without disabilities to see if there were any differences in pregnancy, delivery, and infant health. The study found that women with these conditions had a higher risk of certain complications during pregnancy and delivery, but their infants did not have increased long-term health problems.

Study Duration
1987–2012
Participants
529 women with spinal cord injury (SCI), paralysis, or spina bifida (SB) and a comparison group of women without disabilities
Evidence Level
III

Key Findings

  • 1
    Women with SCI, paralysis, or SB had increased risks of prenatal urinary tract infection/pyelonephritis.
  • 2
    Women with SCI, paralysis, or SB had increased risks of venous thromboembolism.
  • 3
    Infants of women with these conditions were more often small for gestational age.

Research Summary

This population-based study examined pregnancy, delivery, and neonatal outcomes for women with SCI, paralysis, and SB. Infants of women with these conditions did not experience greater risk of longer-term adverse outcomes despite being more likely to be born preterm or small for gestational age. Mothers had increased risks of complications like UTI, preterm delivery, cesarean delivery, VTE/PE, obstructed labor, and postpartum depression.

Practical Implications

Preconception Counseling

Optimization of preconception counseling and medical management for conditions such as tobacco use, diabetes, and hypertension is crucial.

Close Monitoring During Pregnancy

Close observation during pregnancy for monitoring and management of complications such as UTIs is essential.

Postpartum Surveillance

Careful postpartum surveillance, especially in the first year, is needed to address risks of depression and injury.

Study Limitations

  • 1
    Use of ICD9 codes may have resulted in under-ascertainment of outcomes.
  • 2
    Lack of data on severity of disability, functional status, and mobility.
  • 3
    Out-migration during the 2-year follow-up may have affected risk estimates.

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