Postpartum Readmission in People with Intellectual and Developmental Disability.

Introduction: Postpartum readmission (PPR) 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 (IDD), including the autism spectrum. The purpose of the study is to establish an estimate of PPR in a nationally representative sample of people with IDD.

Methods: this study used the National Readmission Database to examine the deliveries of people with IDD (n=5721), people on the autism spectrum (n=1099) and deliveries in people without IDD or autism (n=3,890,553) in 2019 and 2020. Log-binomial regression was used to examine person and delivery characteristics associated with PPR in all deliveries.

Results: PPR was more common in people with IDD (6.6%) and people on the autism spectrum (3.3%) than in all other deliveries (1.5%). In adjusted analyses, people with IDD (aRR 3.50, 95% CI 3.15, 3.90) and people on the autism spectrum (aRR 2.06, 95% CI 1.42, 2.97) had increased risk of PPR compared to people without these conditions. Other characteristics were also associated with increased risk of PPR, including 2.80 times the risk of PPR in people with severe maternal morbidity compared to those without (95% CI 2.66, 2.94).

Conclusions: High rates of PPR in people with IDD 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.