Postpartum Readmission in People With Intellectual and Developmental Disability.

This study looked at hospital readmissions after childbirth for autistic women and women with intellectual disabilities. They found that autistic women were twice as likely to be readmitted to hospital after giving birth compared to other women, while women with intellectual disabilities were over three times more likely. The researchers suggest this might be due to other health conditions, less social support, or difficulties accessing appropriate healthcare.

This large-scale study analyzed postpartum readmission rates using the National Readmission Database, examining deliveries among people with intellectual and developmental disabilities (n=5,721), autism spectrum conditions (n=1,099), and neurotypical controls (n=3,890,553) in 2019-2020. Results showed significantly elevated postpartum readmission rates: 6.6% for people with intellectual and developmental disabilities, 3.3% for autistic individuals, compared to 1.5% for controls. After adjusting for confounding factors, people with intellectual and developmental disabilities had 3.50 times higher risk and autistic people had 2.06 times higher risk of postpartum readmission. The study highlights substantial healthcare disparities and suggests that differences in co-occurring conditions, social support, and healthcare accessibility may contribute to these elevated readmission rates.

Results indicate need for enhanced postpartum care protocols for autistic individuals, including closer monitoring, accessible healthcare services, and improved social support systems. Healthcare providers should be aware of increased readmission risk and implement preventive strategies during initial postpartum period.

Study design not specified in abstract. Limited to readmissions within database timeframe. Does not identify specific causes of readmission or examine quality of initial care. Lacks information about severity of disabilities or individual support needs.

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.