Pregnancy and postnatal outcomes for women with intellectual disability and their infants: A systematic review

Background: While the perinatal period is a vulnerable time for women and their infants, it is also a window to promote adjustment and support. Women with intellectual disability might be a uniquely vulnerable group owing to pre-existing health and care inequalities. The aim of this paper is to explore the pregnancy and postnatal outcomes of women with intellectual disability and the health and development of their infants. Methods: Three electronic databases (MEDLINE, PsycINFO, EMBASE) were searched for peer-reviewed papers that reported maternal pregnancy variables and infant outcomes within the first 12 months of life. Two reviewers screened 103 full text articles, of which nine met eligibility criteria. Data reporting maternal health, pregnancy complications, labour variables, and birth and neonatal outcomes were extracted, and findings were summarised narratively. Findings: Women with intellectual disability were at an overall higher risk of adverse obstetric and pregnancy outcomes, such as urinary tract infection, gestational hypertension, and postpartum haemorrhage. Similarly, infants of women with intellectual disability had higher rates of premature birth, perinatal mortality, and experienced longer hospital stays when compared to their counterparts born to women without intellectual disability. Conclusions: The relative sparsity of literature in this field demonstrates the need for further focused study on the pregnancy and postnatal outcomes of women with intellectual disability and their infants. Nonetheless, findings indicate that maternity services need to be further developed to provide optimum care for women with intellectual disability and to support infant development.