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Pregnancy, labor, and delivery outcomes of women with and without spinal cord injury. 2023

Amie B McLain, and Lena Zhang, and Jan Troncale, and Yu Ying Chen, and Claire Kalpakjan
Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.

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 (1:2 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.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003668 Pressure Ulcer An ulceration caused by prolonged pressure on the SKIN and TISSUES when one stays in one position for a long period of time, such as lying in bed. The bony areas of the body are the most frequently affected sites which become ischemic (ISCHEMIA) under sustained and constant pressure. Bedsore,Decubitus Sore,Decubitus Ulcer,Pressure Injury,Pressure Sore,Bed Sores,Bed Sore,Bedsores,Decubitus Sores,Decubitus Ulcers,Injury, Pressure,Pressure Injuries,Pressure Sores,Pressure Ulcers,Sore, Bed,Sore, Decubitus,Sore, Pressure,Ulcer, Decubitus,Ulcer, Pressure
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D013119 Spinal Cord Injuries Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., WOUNDS, GUNSHOT; WHIPLASH INJURIES; etc.). Myelopathy, Traumatic,Injuries, Spinal Cord,Post-Traumatic Myelopathy,Spinal Cord Contusion,Spinal Cord Laceration,Spinal Cord Transection,Spinal Cord Trauma,Contusion, Spinal Cord,Contusions, Spinal Cord,Cord Contusion, Spinal,Cord Contusions, Spinal,Cord Injuries, Spinal,Cord Injury, Spinal,Cord Laceration, Spinal,Cord Lacerations, Spinal,Cord Transection, Spinal,Cord Transections, Spinal,Cord Trauma, Spinal,Cord Traumas, Spinal,Injury, Spinal Cord,Laceration, Spinal Cord,Lacerations, Spinal Cord,Myelopathies, Post-Traumatic,Myelopathies, Traumatic,Myelopathy, Post-Traumatic,Post Traumatic Myelopathy,Post-Traumatic Myelopathies,Spinal Cord Contusions,Spinal Cord Injury,Spinal Cord Lacerations,Spinal Cord Transections,Spinal Cord Traumas,Transection, Spinal Cord,Transections, Spinal Cord,Trauma, Spinal Cord,Traumas, Spinal Cord,Traumatic Myelopathies,Traumatic Myelopathy
D020211 Autonomic Dysreflexia A syndrome associated with damage to the spinal cord above the mid thoracic level (see SPINAL CORD INJURIES) characterized by a marked increase in the sympathetic response to minor stimuli such as bladder or rectal distention. Manifestations include HYPERTENSION; TACHYCARDIA (or reflex bradycardia); FEVER; FLUSHING; and HYPERHIDROSIS. Extreme hypertension may be associated with a STROKE. (From Adams et al., Principles of Neurology, 6th ed, pp538 and 1232; J Spinal Cord Med 1997;20(3):355-60) Autonomic Hyperreflexia,Dysreflexia, Autonomic,Hyperreflexia, Autonomic,Spinal Autonomic Dysreflexia,Autonomic Dysreflexia, Spinal,Autonomic Dysreflexias,Autonomic Dysreflexias, Spinal,Autonomic Hyperreflexias,Dysreflexia, Spinal Autonomic,Dysreflexias, Autonomic,Dysreflexias, Spinal Autonomic,Hyperreflexias, Autonomic,Spinal Autonomic Dysreflexias

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