Soins obstétricaux et santé pendant la grossesse chez les personnes autistes et celles ayant d'autres déficiences développementales dans un système de soins de santé intégré en Californie

Titre original en anglais : Obstetric Care and Pregnancy Health in Autistic Individuals and Those with Other Developmental Disabilities in an Integrated Health Care Setting in California

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Ames, J., Anderson, M., Cronbach, E., Gassner, D. L., Greenberg, M., Lee, C., Giwa Onaiwu, M., & Croen, L. A. (2025). Obstetric Care and Pregnancy Health in Autistic Individuals and Those with Other Developmental Disabilities in an Integrated Health Care Setting in California. Autism in Adulthood. https://doi.org/10.1089/aut.2024.0323

Date de publication: 08/07/2025 Ajout dans AutiHub: 05/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
8
Auteur·ices de la publication identifié·es comme autistes
2 / 8 (25,0 %)
  1. Jennifer Ames
  2. Meredith Anderson
  3. Emily Cronbach
  4. Dena L. Gassner *
  1. Mara Greenberg
  2. Catherine Lee
  3. Morénike Giwa Onaiwu *
  4. Lisa A. Croen

Résumé

Contexte : Les premières données suggèrent que les personnes autistes font face à des difficultés particulières concernant la santé pendant la grossesse, y compris des risques accrus de dépression périnatale et de complications de la grossesse telles que la naissance prématurée. Nous avions pour objectif de comparer la santé pendant la grossesse et le recours aux soins obstétricaux chez les personnes autistes, celles ayant d'autres déficiences développementales (DD) et celles issues de la population générale (PG) aux États-Unis. Méthodes : Dans Kaiser Permanente Northern California, nous avons identifié toutes les grossesses survenues entre janvier 1997 et juillet 2024 chez des membres ayant un diagnostic d'autisme documenté par un clinicien (n = 431) ou une autre DD (n = 3893). À partir des dossiers de santé électroniques, nous avons extrait des données sur les diagnostics pendant la grossesse et le post-partum, les issues de naissance et le recours aux soins obstétricaux. Nous avons apparié les grossesses de la PG selon un ratio de 100:1 (n = 43 100) sur l'année de naissance et le statut de grossesse unique ou multiple au groupe autiste. Nous avons utilisé une régression logistique ajustée pour comparer les issues et le recours aux soins entre les trois groupes. Résultats : Comparativement à la PG, les groupes autiste et DD présentaient des taux plus élevés d'hyperémèse gravidique (6,1 % et 3,3 % contre 1,9 %), de dépression prénatale (52,8 % et 27,7 % contre 15,6 %) et de naissance prématurée (11,2 % et 14,2 % contre 7,5 %). De plus, le groupe autiste présentait un taux plus élevé d'avortement thérapeutique, tandis que le groupe DD présentait des taux plus élevés de troubles hypertensifs liés à la grossesse que la PG. Nous n'avons pas observé de disparités dans l'utilisation des soins prénatals standard. Toutefois, les groupes autiste et autre DD étaient tous deux plus susceptibles que la PG de consulter le service des urgences pendant la grossesse et le post-partum et d'accoucher par césarienne. En outre, le groupe DD était moins susceptible que la PG d'avoir une consultation post-partum. Conclusions : Ces résultats soulignent l'importance de répondre aux besoins obstétricaux particuliers des personnes autistes et de celles ayant d'autres DD, notamment en facilitant l'accès aux services de planification familiale, en améliorant la qualité des soins prénatals et post-partum et en fournissant un soutien adéquat en santé mentale périnatale.

Background: Early evidence suggests that autistic individuals face unique challenges around pregnancy health, including increased risks of perinatal depression and pregnancy complications such as preterm birth. We aimed to compare pregnancy health and obstetric care utilization among autistic individuals, those with other developmental disabilities (DDs), and those from the general population (GP) in the United States. Methods: In Kaiser Permanente Northern California, we identified all pregnancies that occurred between January 1997 and July 2024 among members with a clinician-documented autism diagnosis ( n = 431) or other DD ( n = 3893). From electronic health records, we extracted data on diagnoses during pregnancy and postpartum, birth outcomes, and obstetric care utilization. We matched pregnancies among the GP 100:1 ( n = 43,100) on birth year and singleton/multiple status to the autistic group. We used adjusted logistic regression to compare outcomes and utilization between the three groups. Results: Compared with the GP, the autistic and DD groups had higher rates of hyperemesis gravidarum (6.1% and 3.3% vs. 1.9%), prenatal depression (52.8% and 27.7% vs. 15.6%), and preterm birth (11.2% and 14.2% vs. 7.5%). Additionally, the autistic group had a higher rate of therapeutic abortion, whereas the DD group had higher rates of pregnancy-related hypertensive disorders than the GP. We did not see disparities in the use of standard prenatal care. However, both the autistic and other DD groups were more likely than the GP to visit the emergency department during pregnancy and postpartum and deliver via cesarean section. Furthermore, the DD group was less likely than the GP to have a postpartum visit. Conclusions: These findings emphasize the importance of addressing the unique obstetric needs of individuals with autism and other DDs, including facilitating access to family planning services, enhancing the quality of prenatal and postpartum care, and providing adequate perinatal mental health support.

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Vue d’ensemble de l’inclusion dans la bibliographie

Ces indicateurs décrivent la bibliographie citée importée pour cette publication. Les métriques de références citées utilisent le total des références citées comme dénominateur. Les métriques d’auteurices cité·es indiquent si elles utilisent toutes les occurrences d’auteurices cité·es ou seulement les occurrences rattachées à des auteurices déjà intégré·es à la base de données AutiHub. Ils utilisent les rattachements mis en cache entre les auteurices cité·es et les auteurices intégré·es à la base de données AutiHub. Dernier calcul : 16/08/2026 11:30.

Références citées
64
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
1 / 64 (1,6 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
1 / 335 (0,3 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 1 / 61 (1,6 %). Auteurices cité·es distinct·es identifié·es comme autistes : 1 / 282 (0,4 %).
Occurrences citées rattachées à la base AutiHub
61 / 335 (18,2 %)
Auteurices cité·es distinct·es rattaché·es : 33 / 282 (11,7 %)
Occurrences rattachées, non identifiées comme autistes
60 / 61 (98,4 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 60 / 335 (17,9 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 32 / 33 (97,0 %).
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