Evidence map›Paper›PMID 41711183›Full record

ArticlePaediatric and perinatal epidemiology2026

Fertility Rates Among Women With Intellectual and Developmental Disability Enrolled in Medicaid and/or Medicare, 2011-2022.

Josue Antonio G Estrada, Nina Cesare, Katherine Barger, Emily Q Sisson, Megan B Cole, Laura Graham Holmes, Samantha E Parker, Alianna Higgins, Collette N Ncube, Samuel B Rosenberg and 4 more

Erratum issuedAbstract read
In one paragraph

Article in Paediatric and perinatal epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Josue Antonio G EstradaDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-5199-2933
Nina CesareCenter for Health Data Science, Boston University School of Public Health, Boston, Massachusetts, USA.
Katherine BargerCenter for Health Data Science, Boston University School of Public Health, Boston, Massachusetts, USA.
Emily Q SissonCenter for Health Data Science, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-9574-2909
Megan B ColeDepartment of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA.
Laura Graham HolmesSchool of Social Work, Hunter College, City University of New York, New York, New York, USA.
Samantha E ParkerDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-7193-077X
Alianna HigginsDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0009-0001-9515-0639
Collette N NcubeDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-0661-9926
Samuel B RosenbergDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-0537-9729
Ashley ScottDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0009-0009-0727-8914
Sowmya R RaoDepartment of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.
Martha WerlerDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-3392-6814
Eric RubensteinDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-9146-4497

Funding

Research Center in Minority Institutions (RCMI) at City CollegeU54MD017979 · NIMHD · CITY COLLEGE OF NEW YORK · PI M. Felice Marina GHILARDI · 2024 to 2026
$15.9M
Improving pregnancy outcomes for women with intellectual and developmental disabilities in MedicaidR01HD109135 · NICHD · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Eric S Rubenstein · 2023 to 2026
$2.6M
Eunice Kennedy Shriver National Institute of Child Health and Human Development 1R01HD109135NICHD NIH HHS R01 HD109135NIMHD NIH HHS U54 MD017979
6 · The paper itself

Abstract

backgroundWomen with intellectual and developmental disability (IDD), including those with autism and/or intellectual disability, have historically been sterilised and institutionalised to limit their reproductive rights. As sterilisation laws have been repealed and protections against institutionalisation enacted, stigma persists but may be changing over time.

objectivesOur objective was to describe fertility rates among women with identified IDD (defined using ICD codes for intellectual disability or autism) using 11 years of data of all women aged 18-45 and enrolled in Medicaid and/or Medicare.

methodsWe identified a cohort of women with IDD enrolled in Medicaid and/or Medicare between January 2011 and December 2022. International Classification of Diseases (ICD) 9 and 10 codes were used to identify pregnancies and IDD diagnoses. We calculated general fertility rate (GFR), age-specific fertility rate (ASFR) and total fertility rate (TFR) and corresponding 95% confidence intervals (CI) for each year.

resultsFrom 2011 to 2022, we observed 50,562 livebirths among 33,457 women. There were 38,983 births to women with intellectual disability, 9360 with autism, and 2219 with autism and co-occurring intellectual disability. There were 1403 pregnancies to women with cerebral palsy and autism or intellectual disability. GFR in women with IDD was relatively stable over the years, from 9.3 per 1000 (95% CI 9.0, 9.6) in 2011 to 9.9 per 1000 (95% CI 9.6, 10.2) in 2022. ASFR for both women with autism-only and women with an intellectual disability-only was highest at 21-25 years. Total fertility rates were slightly higher for those with autism-only (ranging from 0.22 to 0.40 across years) than for women with intellectual disability-only (ranging from 0.25 to 0.27). Data also reveal that fertility rates for women with IDD have increased in most states.

conclusionTrends in fertility rates among women with IDD were consistent over time. Incremental increase in fertility rates were observed among women with autism. Results warrant the need to further examine factors related to access, quality and continuity of care among women with IDD.

Indexed as

Birth RateDevelopmental DisabilitiesIntellectual DisabilityMedicaidMedicareAdolescentAdultFemaleHumansMiddle AgedPregnancySterilization, ReproductiveUnited StatesYoung Adultautismdisability justicefertility ratehealth insuranceintellectual and developmental disabilityMedicaid and Medicare

Identifiers

PMID41711183
PMCPMC12993431

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Registered trials

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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.