Maternal Disability Linked to Higher Infant ED Use

TOPLINE:

Infants born to mothers with disabilities had higher rates of emergency department (ED) visits in their first year of life than those born to mothers without disabilities.

METHODOLOGY:

• Researchers conducted a population-based study of 1,596,932 live-born infants from April 1, 2008, to March 31, 2021, in Canada.
• A total of 139,698 infants (8.7%) were born to women with a physical disability; among them, 48,112 infants were born to women with a sensory disability, 2547 were born to women with an intellectual or developmental disability, and 10,312 were born to women with multiple disabilities.
• The primary outcome was any ED visit within the first year of life.

TAKEAWAY:

• ED visits were more common among infants born to mothers with physical (46.9%), sensory (45.2%), intellectual or developmental (55.4%), or multiple (51.0%) disabilities than among those born to mothers without disabilities (40.0%). These differences corresponded to 12%, 7%, 17%, and 14% higher odds of ED use, respectively.
• Infants of mothers with disabilities had more ED visits both before 28 days of life and between 28 and 365 days, with the highest risks seen among infants of mothers with intellectual or developmental disabilities (adjusted hazard ratios of 1.58 and 1.41 for the respective time periods).
• Similar patterns were observed for ED visits for high-acuity, moderate-acuity, and low-acuity cases.
• ED visit characteristics (timing, diagnosis, discharge destination, and rates of follow-up with the primary care physician) were similar regardless of maternal disability status.

IN PRACTICE:

“This cohort study found that infants of women with a disability were more likely than infants of women without disabilities to have an ED visit and repeat ED visits, although the timing, diagnosis, discharge disposition, and rates of follow-up with the primary care physician within 7 days were similar,” the authors wrote. “These findings suggest that more could be done for infants of women with a disability to prevent nonurgent ED visits, reduce risk factors for urgent ED visits, and support families when ED visits occur,” they added.

SOURCE:

The study was led by Hilary K. Brown, PhD, University of Toronto Scarborough, Toronto, Ontario, Canada, and was published online on May 5, 2025, in JAMA Network Open.

LIMITATIONS:

Misclassification of disability status was a limitation. Additionally, the study lacked information on the severity of disability, the preventability of ED visits in outpatient settings, and the circumstances surrounding the decision to seek ED care, such as the quality of the relationship with the primary care physician, transportation issues, or distance to care.

DISCLOSURES:

The study was supported by the Institute for Clinical Evaluative Sciences. The authors reported receiving grants from various sources, including the Canadian Institutes of Health Research.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.