Evidence map›Paper›PMID 40146109›Full record

ArticleJAMA network open2025

Identifying Pregnant Women With Disabilities and Maternal and Newborn Outcomes.

Alka Dev, Willi Horner-Johnson, Andrew Schaefer, Cecilia Ganduglia-Cazaban, Thérèse A Stukel, David C Goodman, JoAnna K Leyenaar

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alka DevThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Willi Horner-JohnsonOregon Health and Science University Institute on Development and Disability, Portland.
Andrew SchaeferThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Cecilia Ganduglia-CazabanCenter for Healthcare Data, UTHealth Houston School of Public Health, Houston, Texas.
Thérèse A StukelICES, Toronto, Ontario, Canada.
David C GoodmanThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
JoAnna K LeyenaarThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

Funding

Determinants of Newborn Health and Health Care Trajectories in the First Year of LifeR01HD101523 · NICHD · DARTMOUTH COLLEGE · PI GOODMAN, DAVID C. · 2021 to 2024
$2.5M
Evaluating maternal and newborn health inequities at the intersection of race, ethnicity, and disability in the U.SK01MD018638 · NIMHD · DARTMOUTH COLLEGE · PI Alka Dev · 2023 to 2026
$545k
NICHD NIH HHS R01 HD101523NIMHD NIH HHS K01 MD018638
6 · The paper itself

Abstract

Importance: Pregnant women with disabilities are at higher risk of poor pregnancy and birth outcomes. Different methods for identifying disability may affect estimates of health disparities in this population. Objective: To compare pregnancy and birth outcomes among pregnant women using different ways of identifying maternal disability. Design, Setting, and Participants: Retrospective cohort study of linked vital records and maternal and newborn claims for Medicaid-insured live births from January 2010 to December 2014 in Texas. Data analysis was conducted from October 2023 to May 2024. Exposure: Births grouped into 5 maternal cohorts: no identified disability, disability benefits enrollment only, disability diagnostic code only, both benefits enrollment and a diagnostic code, and either disability benefits or a diagnostic code. Main Outcomes and Measures: Mode of delivery (cesarean) and severe maternal morbidity (SMM) were identified from maternal claims. Low birthweight (LBW), preterm birth (PTB), and small for gestational age (SGA) were identified from birth certificates. Modified Poisson regression with robust variance estimators was used to estimate adjusted risk ratios (aRRs) for the association of each of the 5 outcomes with disability group status. Results: Among 921 218 births (mean [SD] maternal age at birth, 25.1 [5.7] years), 895 201 (97.2%) were to mothers with no disability, 6160 (0.7%) were to mothers enrolled in disability benefits only, 17 742 (1.9%) were to mothers with a disability diagnostic code only, 2115 (0.2%) were to mothers with both benefits enrollment and a disability code, and 26 017 (2.8%) were to mothers meeting either disability definition. Compared with those without disabilities, those with only disability diagnostic codes had the highest rates for cesarean delivery (306 589 births [34.3%] vs 7658 births [43.2%]), LBW (750 058 births [8.4%] vs 869 births [14.2%]), and PTB (92 807 births [10.4%] vs 977 births [15.9%]). Compared with those with no disability, the adjusted relative risks were highest in the diagnostic codes only group for cesarean delivery (aRR, 1.22; 95% CI, 1.20-1.24), LBW (aRR, 1.77, 95% CI, 1.71-1.84), and PTB (aRR, 1.68; 95% CI, 1.62-1.74). The risk for SMM (aRR, 4.82; 95% CI, 3.96-5.86) and SGA (aRR, 1.43; 95% CI, 1.24-1.66) were highest in those with both benefits enrollment and a disability code. Conclusions and relevance: In this cohort study, disability was associated with adverse outcomes, regardless of definition. However, the burden of disparities was dependent on how disability was defined, suggesting that the assessment of disability-associated health risks should consider how disability is conceptualized.

Indexed as

Persons with DisabilitiesPregnancy ComplicationsPregnancy OutcomeAdultCesarean SectionFemaleHumansInfant, Low Birth WeightInfant, NewbornInfant, Small for Gestational AgeMedicaidPregnancyPremature BirthRetrospective StudiesTexasUnited States

Identifiers

PMID40146109
PMCPMC11950893

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.