Pregnancy and childbirth are associated with physiologic changes that impact most organ systems. Typical physiologic changes associated with pregnancy and those unique to spinal cord injury (SCI) can temporarily or permanently affect the health and function of women with SCI who become pregnant. From a review of original articles published in the English language from January 1990 through June 2010, 16 studies were identified; 3 were excluded and 13 were analyzed. Of these, 12 were case series and 1 was a case-control study in which rates of maternal and fetal complications were compared between pregnancies before injury and those after injury. We conclude that there is a paucity of literature available on pregnancy outcomes in women with SCI. From the available evidence, it appears that worsened spasticity, autonomic dysreflexia, urinary tract infections, and thrombosis are reported more often than expected during pregnancy in women with SCI. SCI seems to increase the risk of obstetric complications such as preterm delivery, low birth weight, and rates of admission to the neonatal intensive care unit. Published surveys have found that most women with SCI do not feel that they had received adequate information about pregnancy during their childbearing years or prior to becoming pregnant. Similarly, most surveyed obstetricians are not very comfortable in managing pregnancy in women with SCI. Our review of the current state of the evidence on the reciprocal effects of pregnancy and SCI will serve as the basis for an extensive portfolio of educational materials aimed at consumers with SCI and the professionals serving them. Further, identified gaps in the literature will serve to guide future research in this area.
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