Pregnancy, labor, and delivery outcomes of women with and without spinal cord injury

Abstract

Objectives: Compare outcomes in pregnant women with and without Spinal Cord Injury (SCI).

Design: Case study and inception cohort comparison.

Setting: Community, primary care/referral center and university practice.

Participants: Twenty-eight pregnant women (12 with SCI ( = PW-SCI) and 16 without SCI ( = PW-AB)) were enrolled. Six PW-SCI left study and six completed data collection and were matched, by age, parity, and race, with 12 PW-AB (1:2 ratio, respectively). Final analysis included 18 (78%) subjects.

Interventions: Not applicable.

Main Outcome Measures: Utilizing standardized, templated medical records (published by NIH/NICHHD and DHHS) and self-report, prospective, longitudinal and retrospective details of pregnancy, labor and delivery experiences/complications were recorded for all women and their neonates. Data collection included vital signs, urinalysis, pregnancy-related conditions/complications (i.e. UTIs, hyperglycemia), and labor, delivery, fetal outcomes. For PW-SCI, demographics, occurrences of autonomic dysreflexia (AD), pressure sores, worsening SCI conditions (i.e. spasticity, bladder spasms, lost independence) were recorded.

Results: PW-SCI had statistically greater (P < .05) UTIs than PW-AB (three (50%) to 0 (0%), respectively). One PW-SCI (17%) reported pressure sores and one AD. Three (50%) PW-SCI and 4 (33%) PW-AB experienced a complication at delivery. Newborn mean birth weight (2854 g vs 3578 g; P = 0.12), and length (49.3 vs 45.8 cm; P = 0.32) were lower for PW-SCI than PW-AB. Head circumference was significantly less for PW-SCI than PW-AB (30.3 vs 34.5 cm; P = 0.04).

Conclusions: Women with SCI tend to have more complicated courses of pregnancy, labor and delivery and smaller newborns than non-SCI peers. Neonatal head circumference is significantly smaller.

Keywords:

• Women with spinal cord injury
• Pregnancy
• Labor
• delivery
• Reproductive health

Acknowledgements

The results of the study were presented at the American Spinal Injury Association (ASIA) 45th Annual Meeting, Honolulu Hawaii, April 2–5, 2019, and the International Spinal Cord Society (ISCoS) 58th Annual Meeting, Nice, France, November 5–7, 2019.

Disclaimer statements

Contributors None.

Funding This work was developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90SI5019). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The content does not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

Conflicts of interest Authors have no conflicts of interests to declare.