Postpartum Readmission in People With Intellectual and Developmental Disability

Area of Science:

• Maternal Health
• Disability Studies
• Public Health

Background:

• Rising rates of postpartum readmission and severe maternal morbidity in the U.S.
• Limited data on postpartum readmission risks for individuals with intellectual and developmental disabilities (IDD), including autism spectrum disorder (ASD).

Purpose of the Study:

• To estimate postpartum readmission rates in a nationally representative sample of individuals with IDD.
• To compare readmission risks between individuals with IDD, ASD, and the general population.

Main Methods:

• Utilized the National Readmission Database (NRD) for deliveries in 2019-2020.
• Analyzed data for individuals with IDD (n=5,721), ASD (n=1,099), and without these conditions (n=3,890,553).
• Employed log-binomial regression to identify factors associated with postpartum readmission.

Main Results:

• Postpartum readmission was more frequent in individuals with IDD (6.6%) and ASD (3.3%) compared to the general population (1.5%).
• Individuals with IDD had a 3.50-fold increased risk (aRR=3.50) and those with ASD had a 2.06-fold increased risk (aRR=2.06) of postpartum readmission.
• Severe maternal morbidity was associated with a 2.80-fold increased risk of readmission.

Conclusions:

• Elevated postpartum readmission rates in individuals with IDD necessitate further investigation into contributing factors.
• Potential drivers include co-occurring health and mental health conditions, social support, and healthcare accessibility.
• Findings underscore the need for targeted interventions to improve postpartum care for individuals with IDD and ASD.