Adverse Birth Outcomes in Pregnant Women With Intellectual and/or Developmental Disabilities by Substance Use Disorder Status

There remains a gap in research examining substance use disorder (SUD) during pregnancy among women with intellectual and/or developmental disabilities (IDDs). This study investigates the association between SUD and birth outcomes in this population. This retrospective cohort study analyzed 5,512 births from 2,445 mothers with IDDs using the Utah Population Database (1996–2018). Outcomes included preterm birth, low birth weight, cesarean delivery, congenital anomalies, and neonatal intensive care unit (NICU) admission. Random-effects logistic regression models were applied. Among all births, 18.8% were to mothers with SUD, with this rate increasing from 8% in 1996 to 48% in 2018. SUD was associated with a 57% higher risk of preterm birth (OR = 1.57, <i>p</i> = 0.01). Low birth weight was more common in the SUD group, with a 90% increased risk (OR = 1.90, <i>p</i> &lt; 0.01). SUD was also linked to higher rates of cesarean delivery (OR = 2.22, <i>p</i> = 0.02), while it was not significantly associated with NICU admission (OR = 1.43, <i>p</i> = 0.11). This study reveals significant associations between SUD and adverse birth outcomes in pregnant individuals with IDDs. The findings underscore the need for targeted interventions to mitigate risks and improve access to prenatal care.