Cancer Epidemiology Research Cooperative (CERC)


POWDER Study (Pregnancy Outcomes in Women with Disabilities: Epidemiologic Research)

Principal Investigator: Beth A. Mueller, DrPH
Co-Investigators:        Melissa Schiff, MD, MPH
                                   Deb Crane, MD, MPH

The prevalence of disability among Americans is increasing, with higher levels among women than men. Women with disabilities may face extra challenges or have characteristics placing them or their infants at increased risk of adverse outcomes such as low birth weight or prematurity.  Childbearing among women with disabilities has increased, but few studies have examined pregnancy course and birth outcomes among women with chronic conditions that may restrict mobility or care access, or which may alter their health status during pregnancy or impact their own, or their child’s health after birth. Most prior studies were based on small numbers of women from single clinics, and so results may not represent the larger population.

Given the growing numbers of these women who are having babies, it is important to improve our understanding of how they may achieve healthy outcomes and offspring. Investigators from the University of Washington and the Fred Hutch are collaborating in this study, which uses existing birth certificate and hospital discharge data to examine pregnancy outcomes in women with physical, intellectual, and other disabilities.  The conditions we will examine include multiple sclerosis; paralyses and conditions that limit mobility such as cerebral palsy, spinal cord injury, rheumatoid arthritis and ankylosing spondylitis, polio, stroke; or spina bifida; muscular and other dystrophies; epilepsy and systemic lupus; cystic fibrosis; blindness, deafness; and intellectual disabilities.

The aims of our study are to:

  • Describe the numbers and proportions of deliveries to women with disabilities in Washington State over time.
  • Compare the occurrence of adverse pregnancy conditions and outcomes such as having a low birth weight infant, delivering preterm, and the need for re-hospitalization after delivery, among women with these disabilities to the occurrence of these outcomes among a large randomly selected group of women without disabilities who have deliveries during the same years in Washington State.

Associations we may find between the presence of specific conditions and the occurrence of adverse pregnancy outcomes could provide physicians with new insights into how best to care for women with disability during, and after their pregnancies and deliveries.

We welcome input from individuals with insights into the care of these women, and from women with disabilities.

Melissa Schiff, MD, MPH                 Beth Mueller, DrPH                                           Deb Crane, MD, MPH
Epidemiology Professor                  Epidemiology Professor                                   Assistant Professor of
and Ob-Gyn consultant at              University of Washington                                  Rehabilitation Medicine
the University of Washington          and Researcher,                                               University of Washington/
Email: mschiff@uw.edu                  Fred Hutchinson Cancer Research Center       Harborview Medical Center  
                                                       Email: bmueller@fhcrc.org                               Email: dacrane@uw.edu
                                                       Tel: 206-667-4630

Members of the study team will be attending the following meetings and events:
To be determined.