Current pregnancy among women with spinal cord injury: Findings from the US national spinal cord injury database

Abstract

Study design:Cross-sectional studyObjectives:To examine the prevalence of pregnancy and associations with sociodemographic and clinical factors among women with spinal cord injury (SCI)Setting:US National Spinal Cord Injury Database, an SCI registry that interviews participants 1, 5 and then every 5 years post injury. Data include SCI clinical details, functional impairments, participation measures, depressive symptoms and life satisfaction. Women aged 18-49 are asked about hospitalizations in the last year relating to pregnancy or its complications. Data represent 1907 women, who completed 3054 interviews.Methods:We used generalized estimating equations to examine bivariable associations between pregnancy and clinical and psychosocial variables and to perform multivariable regressions predicting pregnancy.Results:Across all women, 2.0% reported pregnancy during the prior 12 months. This annual prevalence differed significantly by the years elapsed since injury; the highest rate occurred 15 years post injury (3.7%). Bivariable analyses found that younger age at injury was significantly associated with current pregnancy (P<0.0001). Compared with nonpregnant women, those reporting current pregancy were significantly more likely to be married or partnered, have sport-related SCI, have higher motor scores and have more positive psychosocial status scores. Multivariable analyses found significant associations between current pregnancy and age, marital status, motor score and mobility and occupation scale scores.Conclusion:Current pregnancy rates among reproductive-aged women with SCI are similar to rates of other US women with chronic mobility impairments. More information is needed about pregnancy experiences and outcomes to inform both women with SCI seeking childbearing and clinicians providing their care.Sponsorship:US National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, grant no. R21 HD068756-02 and National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitation Services, US Department of Education, Washington DC (grant no. H133A110002).