Pregnancy in Women With Intellectual and Developmental Disabilities

J Obstet Gynaecol Can. 2016 Jan;38(1):9-16. doi: 10.1016/j.jogc.2015.10.004.


Objective: Our objectives were to describe the general fertility rate (GFR) and age-specific fertility rates (ASFRs) of women with intellectual and developmental disabilities (IDD) and the social and health characteristics of those with a singleton live birth, and to compare these to women without IDD.

Methods: In this population-based retrospective cohort study using linked Ontario health and social services administrative data, we identified 18- to 49-year-old women with IDD (N = 21 181) and without IDD (N = 990 776). The GFR and ASFRs (2009) were calculated for both groups and compared using rate ratios (RR) and 95% confidence intervals (CI). Among women with a singleton live birth (N = 423 with, N = 42 439 without IDD), social and health characteristics were compared using Pearson's Chi square tests.

Results: The GFR in women with IDD (20.3 per 1000) was lower than that in women without IDD (43.4 per 1000) (RR 0.47; 95% CI 0.43 to 0.51). ASFRs in 18- to 24-year-olds were similar in both groups. Among women with a singleton live birth, those with IDD were younger and had higher rates of poverty, epilepsy, obesity, and mental health issues. They also had high rates of medication use during pregnancy.

Conclusion: In the largest study of fertility in women with IDD to date, we found that ASFRs are similar in young women with and without IDD. Women with IDD with a singleton live birth experience significant social and health disparities during pregnancy. These findings suggest the need to develop services to support the reproductive health of this vulnerable group.

Keywords: Birth; Birth rate; Developmental disability; Fertility rate; Intellectual disability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Birth Rate*
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / epidemiology*
  • Female
  • Health Status Disparities
  • Humans
  • Intellectual Disability / diagnosis
  • Intellectual Disability / epidemiology*
  • Middle Aged
  • Ontario / epidemiology
  • Population Surveillance
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Retrospective Studies
  • Sociological Factors