Pregnancy, labor, and delivery outcomes of women with and without spinal cord injury.

ABSTRACT

Objectives: Compare outcomes in pregnant women with and without Spinal Cord Injury (SCI).Design: Case study and inception cohort comparison.Setting: Community, primary care/referral center and university practice.Participants: Twenty-eight pregnant women (12 with SCI ( = PW-SCI) and 16 without SCI ( = PW-AB)) were enrolled. Six PW-SCI left study and six completed data collection and were matched, by age, parity, and race, with 12 PW-AB (12 ratio, respectively). Final analysis included 18 (78%) subjects.Interventions: Not applicable.Main Outcome Measures: Utilizing standardized, templated medical records (published by NIH/NICHHD and DHHS) and self-report, prospective, longitudinal and retrospective details of pregnancy, labor and delivery experiences/complications were recorded for all women and their neonates. Data collection included vital signs, urinalysis, pregnancy-related conditions/complications (i.e. UTIs, hyperglycemia), and labor, delivery, fetal outcomes. For PW-SCI, demographics, occurrences of autonomic dysreflexia (AD), pressure sores, worsening SCI conditions (i.e. spasticity, bladder spasms, lost independence) were recorded.Results: PW-SCI had statistically greater (P < .05) UTIs than PW-AB (three (50%) to 0 (0%), respectively). One PW-SCI (17%) reported pressure sores and one AD. Three (50%) PW-SCI and 4 (33%) PW-AB experienced a complication at delivery. Newborn mean birth weight (2854 g vs 3578 g; P = 0.12), and length (49.3 vs 45.8 cm; P = 0.32) were lower for PW-SCI than PW-AB. Head circumference was significantly less for PW-SCI than PW-AB (30.3 vs 34.5 cm; P = 0.04).Conclusions: Women with SCI tend to have more complicated courses of pregnancy, labor and delivery and smaller newborns than non-SCI peers. Neonatal head circumference is significantly smaller.