Bell Janice F, Zimmerman Frederick J, Cawthon Mary Lawrence, Huebner Colleen E, Ward Deborah H, Schroeder Carole A
Department of Health Services, University of Washington, Seattle, WA 98195, USA.
J Urban Health. 2004 Dec;81(4):630-44. doi: 10.1093/jurban/jth146.
This study examined the relationships between jail incarceration during pregnancy and infant birth weight, preterm birth, and fetal growth restriction. We used multivariate regression analyses to compare outcomes for 496 births to women who were in jail for part of pregnancy with 4,960 Medicaid-funded births as matched community controls. After adjusting for potential confounding variables, the relationship between jail incarceration and birth outcomes was modified by maternal age. Relative to controls, women incarcerated during pregnancy had progressively higher odds of low birth weight and preterm birth through age 39 years; conversely, jail detainees older than 39 years were less likely than controls to experience low birth weight or preterm birth. For women in jail at all ages, postrelease maternity case management was associated with decreased odds of low birth weight, whereas prenatal care was associated with decreased odds of preterm birth. Local jails are important sites for public health intervention. Efforts to ensure that all pregnant women released from jail have access to enhanced prenatal health services may improve perinatal outcomes for this group of particularly vulnerable women and infants.
本研究探讨了孕期入狱与婴儿出生体重、早产及胎儿生长受限之间的关系。我们采用多变量回归分析，将496例孕期部分时间在狱中的女性所生婴儿的结局，与4960例由医疗补助计划资助的、作为匹配社区对照的分娩结局进行比较。在对潜在混杂变量进行调整后，入狱与出生结局之间的关系因母亲年龄而有所改变。相对于对照组，39岁及以下孕期入狱的女性，出生体重低和早产的几率逐渐升高；相反，39岁以上的在押女性比对照组经历低出生体重或早产的可能性更小。对于所有年龄段入狱的女性，出狱后的孕产病例管理与低出生体重几率降低相关，而产前护理与早产几率降低相关。当地监狱是公共卫生干预的重要场所。努力确保所有从监狱释放的孕妇都能获得强化的产前保健服务，可能会改善这一特别脆弱的妇女和婴儿群体的围产期结局。
