548: Reproductive outcomes among women with a disability in the United States

Planning and Development linked Patient Discharge Data and Birth Cohort File from January 1, 1991 through December 31, 2008. We identified maternal risk factors for delivery 39 weeks using candidate variables drawn from the literature, and assessed them using bivariate analyses and logistic regression. RESULTS: Pregnancy-associated and chronic non-reproductive organ-based and systemic diseases, including diabetes, hypertensive disorders, and heart, lung and renal disease, increased significantly over the study period. Older women were disproportionately affected by these health problems, and women with these conditions at any age were more likely to deliver early. Our comparison of fetal and neonatal deaths with live births prior to 39 weeks show a robust correlation, with significant declines in fetal and neonatal death rates accompanying the rise early births. CONCLUSION: Maternal health problems influence birth before 39 weeks to a significantly greater degree than maternal age in this cohort. Providers and consumers wishing to safeguard fetuses and their mothers in the setting of increasingly complicated gestational environments may be driving the trend toward earlier birth without increasing perinatal mortality.