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Pregnancy in Women with Physical Disabilities

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Chair: Sean Blackwell, M.D.

Monday, January 25, 2010
Tuesday, January 26, 2010

Day 1 – Monday, January 26, 2010

8:30 a.m.–9:30 a.m. Registration
9:30 a.m.–9:50 a.m. Welcome, Introductions
Caroline Signore, M.D., M.P.H.
Wanda K. Jones, Dr.P.H.
Sean Blackwell, M.D.

I. Epidemiology

9:50 a.m.–10:05 a.m. Pregnancy and Physical Disability (PDF - 234 KB)
Joanne Thierry, Ph.D., M.S., M.S.W.
The prevalence and type of physical disabilities in women of reproductive age; demographic characteristics; incidence of pregnancy in women with physical disabilities; key research gaps
10:05 a.m.–10:20 a.m. Discussion

II. Available evidence of pregnancy outcome in women with physical disabilities

For specific conditions, brief review of their characteristics; evidence of associated rates of pregnancy outcomes, such as preterm birth, low birth weight, fetal growth restriction, stillbirth, preeclampsia, and postpartum maternal outcome; reciprocal effects of disabling condition and pregnancy; key research gaps
10:20 a.m.–10:35 a.m. Outcomes of Pregnancy in Women withSpinal Cord Injuries 
Amie Jackson, M.D.
10:35 a.m.–10:55 a.m. Outcomes of Pregnancy in Women with Multiple Sclerosis,
Rheumatoid Arthritis
(PDF - 697 KB)
Eliza Chakravarty, M.D., M.S.
10:55 a.m.–11:15 a.m. Outcomes of Pregnancy in Women with Other Disabling Conditions (including cerebral palsy, neural tube defects, and others) (PDF - 849 KB)
Margaret Turk, M.D.
11:15 a.m.–11:30 a.m. Discussion
11:30 a.m.–12:30 p.m. Lunch Break

III. Available evidence of pregnancy-associated risk to mother and baby in women with physical disabilities

12:30 p.m.–1:00 p.m. Risk to Mothers (PDF - 327 KB)
Alessandro Ghidini, M.D.
Evidence of incidence, management, and prevention of pregnancy-associated morbidity (e.g., autonomic dysfunction, urinary tract infection, skin breakdown, pulmonary or cardiovascular dysfunction, and thromboembolic disease) in women with physical disabilities; key research gaps
1:00 p.m.–1:25 p.m. Risk to Infants (PDF - 417 KB) 
Kristi Kirschner, M.D.
Christina Morton, M.D.
Evidence of fetal and infant risks, including medication exposures, congenital anomalies, and key research gaps
1:25 p.m.–1:45 p.m. Psychosocial Risk Factors and Outcomes (PDF - 454 KB)
Margaret Nosek, Ph.D. (virtual attendee)
Evidence of psychosocial risk in women with physical disabilities (e.g., violence, neglect, and substance use); reciprocal influence of pregnancy and psychosocial factors; key research gaps
1:45 p.m.–2:00 p.m. Impact of Stress/Mental Health (PDF - 308 KB)
Rosemary Hughes, Ph.D.
Evidence of the incidence/prevalence of chronic stress and poor mental health in women with physical disabilities; reciprocal influences of stress and mental health and pregnancy; key research gaps
2:00 p.m.–2:20 p.m. Discussion
2:20 p.m.–2:35 p.m. Break

IV. Identifying and overcoming barriers

2:35 p.m.–2:55 p.m. Barriers to Obtaining Appropriate Prenatal Care
Lisa Iezzoni, M.D., M.Sc.
Evidence of barriers to obtaining health care that women with physical disabilities encounter, including socioeconomic, transportation, physical access, and attitudinal barriers; impact of barriers on adequacy of prenatal care; strategies and methods for overcoming barriers to care; key research gaps
2:55 p.m.–3:20 p.m. Barriers to Parenting
Megan Kirshbaum, Ph.D.
Evidence of initiation and maintenance of breastfeeding; strategies to facilitate breastfeeding; the role and development of adaptive methods for newborn care; attitudinal barriers and legal issues faced by parents with physical disabilities; key research gaps
3:20 p.m.–3:50 p.m. Discussion
3:50 p.m.–4:00 p.m. Wrap-up
Sean Blackwell, M.D.
4:00 p.m. Adjourn

Day 2—Tuesday, January 26

8:30 a.m.–9:00 a.m. Breakfast
9:00 a.m.–10:30 a.m. Breakout Groups:
Summarize evidence; reach consensus conclusions where possible; highlight and prioritize
research gaps
  Breakout Group I: Available Evidence of Pregnancy Outcomes in Women with Physical Disabilities
Moderator: Sean Blackwell, M.D.
Rapporteur:  Uma Reddy, M.D., M.P.H.
  Breakout Group II: Available Evidence of Pregnancy-Associated Risk to Mother and Baby in Women with Physical Disabilities
Moderator: Alessandro Ghidini, M.D.
Rapporteur:  Catherine Spong, M.D.
  Breakout Group III: Epidemiology and Identifying and Overcoming Barriers
Moderator: Ahmet Baschat, M.B., B.C.H.
Rapporteur:  Debby Berlyne
10:30 a.m.–10:45 a.m. Break
10:45 a.m.–11:45 a.m. Presentations from Breakout Groups (20 minutes each)
11:45 a.m.–12:45 p.m. Discussion
12:45 p.m.–1:00 p.m. Wrap-up
Sean Blackwell, M.D.
1:00 p.m. Adjourn

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Last Reviewed: 11/30/2012
Vision National Institutes of Health Home BOND National Institues of Health Home Home Storz Lab: Section on Environmental Gene Regulation Home Machner Lab: Unit on Microbial Pathogenesis Home Division of Intramural Population Health Research Home Bonifacino Lab: Section on Intracellular Protein Trafficking Home Lilly Lab: Section on Gamete Development Home Lippincott-Schwartz Lab: Section on Organelle Biology