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Pregnancy Outcomes Among Deaf Women in Washington State, 1987–2012

Schiff, Melissa A. MD, MPH; Doody, David R. MS; Crane, Deborah A. MD, MPH; Mueller, Beth A. DrPH

doi: 10.1097/AOG.0000000000002321
Contents: Original Research

OBJECTIVE: To evaluate pregnancy and neonatal outcomes among deaf women using population-based vital records data in Washington State from 1987 to 2012.

METHODS: We performed a retrospective cohort study using the Washington State birth and fetal death records linked to state hospital discharge records to identify women with diagnosis codes for deafness indicated at their delivery hospitalization and compared them with randomly selected women without these codes. Pregnancy conditions and outcomes evaluated included gestational diabetes, preeclampsia, placental abruption, labor induction, and cesarean delivery. Neonatal outcomes evaluated included preterm gestational age (less than 28, 28 to less than 37 weeks) at delivery and low birth weight. We also assessed length of maternal and neonatal delivery hospitalization. We performed Poisson regression to estimate relative risks (RRs) and 95% CIs for each outcome, adjusting for birth year, maternal age, and parity.

RESULTS: Most adverse pregnancy and neonatal outcomes were similar for deaf and comparison women. Among women who underwent vaginal delivery, deaf women were more than twofold (RR 2.15, 95% CI 1.43–3.22) more likely to have a delivery hospitalization of 4 or more days (6.0% compared with 2.8%). We found a modestly increased risk of cesarean delivery (RR 1.15, 95% CI 1.01–1.30), with 29.9% of deaf compared with 25.6% of nondeaf women having a cesarean delivery.

CONCLUSION: Deaf women are not at increased risk of the majority of adverse pregnancy and neonatal outcomes. Obstetric care providers may use our findings in counseling this special population of prenatal patients.

Deaf women are not at increased risk of most adverse pregnancy outcomes compared with nondeaf women.

Department of Epidemiology, School of Public Health, and the Departments of Obstetrics and Gynecology and Rehabilitation Medicine, School of Medicine, University of Washington, and the Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.

Corresponding author: Melissa A. Schiff, MD, MPH, Department of Epidemiology, School of Public Health, University of Washington, 1959 NE Pacific Street, Box 357236, Seattle, WA 98195; email: mschiff@uw.edu.

Funded by Grant #1R21HD073024 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Financial Disclosure The authors did not report any potential conflicts of interest.

The authors thank the Washington State Department of Health for data access and Mr. Bill O'Brien for data management and programming. Mr. O'Brien's services were paid for by the grant from Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.