Postpartum Readmission in People With Intellectual and Developmental Disability

Postpartum readmission and severe maternal morbidity have been increasing in recent years in the U.S., but little is known about the risk of either for people with intellectual and developmental disabilities, including the autism spectrum. The purpose of the study is to establish an estimate of postpartum readmission in a nationally representative sample of people with intellectual and developmental disabilities.

This study used the National Readmission Database to examine the deliveries in people with intellectual and developmental disabilities (n=5,721), people on the autism spectrum (n=1,099), and people without intellectual and developmental disabilities or autism (n=3,890,553) in 2019 and 2020. Log-binomial regression was used to examine person and delivery characteristics associated with postpartum readmission in all deliveries.

Postpartum readmission was more common in people with intellectual and developmental disabilities (6.6%) and people on the autism spectrum (3.3%) than in all other deliveries (1.5%). In adjusted analyses, people with intellectual and developmental disabilities (adjusted RR=3.50; 95% CI=3.15, 3.90) and people on the autism spectrum (adjusted RR=2.06; 95% CI=1.42, 2.97) had increased risk of postpartum readmission compared with people without these conditions. Other characteristics were also associated with increased risk of postpartum readmission, including 2.80 times the risk of postpartum readmission in people with severe maternal morbidity compared with that in those without (95% CI=2.66, 2.94).

High rates of postpartum readmission in people with intellectual and developmental disabilities point to the need for a better understanding of the drivers of such high rates in these populations. These drivers could include population differences in co-occurring health and mental health conditions, social and community support, and accessible health care.