Mobility Impairments and Pregnancy

Pregnant women with mobility disabilities, such as spinal cord injuries or cerebral palsy, often required treatments for problems related to their functional impairments, a small, interview-based study found.

The study, published in Acta Obstetricia et Gynecologica Scandinavica, was based on in-depth interviews 2 hours in length during 2013 with 22 women who had some type of diagnosed disorder that caused significant mobility difficulties.

Key Points:

- Pregnant women with mobility disabilities are in danger of falls, pressure ulcers, wheelchair fit issues, bladder problems, and other impairments that required treatment.

- Nearly 20% of the participants reported having gestational diabetes or pre-eclampsia/eclampsia.

The interviewers found that the women had several impairment-related complications during their pregnancies. These included falls, urinary tract and bladder problems, wheelchair fit and stability issues, shortness of breath, increased spasticity, and bowel management issues.

Although skin integrity problems were rare, the study also revealed that multiple women had a significant increase in need for skin monitoring during their pregnancy to prevent pressure ulcers. Only one woman reported that a skin integrity problem developed, the authors said.

The falls reported were commonplace, with ten women reporting a fall and two reporting that they broke an arm during the fall. Several others required monitoring by physicians as a result of the falls.

“Weight gain and changes in the center of gravity as pregnancy advanced contributed to fall, which occurred as women transferred into and out of wheelchairs; when women who still ambulated tripped and could not prevent the fall; and when their wheelchair tipped on uneven pavement and women late in pregnancy could not keep themselves from falling to the ground,” the authors wrote.

The authors hope the information they gathered will inform both women and obstetrical clinicians about the possibilities of complications so they can better plan during pregnancy.

“In addition to other pregnancy-associated health risks, women with mobility disabilities appear to experience problems relating to their functional impairments,” the authors concluded. “Pre-conception planning and in-depth discussions during early pregnancy could potentially assist women with mobility disabilities to anticipate and address these difficulties.”

The study authors also asked the women about common pregnancy complications and found that four had gestational diabetes, one developed eclampsia, and three reported pre-eclampsia. In addition, 14 of the women had a cesarean delivery, with 8 of those being elective.