Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON.
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC.
J Obstet Gynaecol Can. 2020 Apr;42(4):462-472.e2. doi: 10.1016/j.jogc.2019.11.068. Epub 2020 Jan 14.
To describe the population-level risk of infant and maternal outcomes for women who experience imprisonment and compare outcomes with the general population.
We conducted a retrospective cohort study. We used linked correctional and health data for women released from provincial prisons in 2010. We defined three exposure groups for Ontario singleton deliveries from 2005-2015: deliveries to women who were in prison during pregnancy but not necessarily for delivery, prison pregnancies; deliveries to women who had been in prison but not while pregnant, prison controls; and general population deliveries. We compared groups using generalized estimating equations. Primary outcomes were preterm birth, low birth weight, and small for gestational age birth weight. Secondary outcomes included NICU admission, neonatal abstinence syndrome, placental abruption, and preterm prelabour rupture of membranes.
In prison pregnancies (n = 544) and prison controls (n = 2156), respectively, preterm birth risk was 15.5% and 12.5%, low birth weight risk was 13.0% and 11.6%, and small for gestational age birth weight risk was 18.1% and 19.2%. Adjusted for maternal age and parity and compared with general population deliveries (N = 1 284 949), odds ratios were increased for prison pregnancies and prison controls, respectively, at 2.7 (95% CI 2.2-3.4) and 2.1 (95% CI 1.9-2.4) for preterm birth, 3.1 (95% CI 2.4-3.9) and 2.7 (95% CI 2.3-3.1) for low birth weight, and 1.6 (95% CI 1.3-2.1) and 1.8 (95% CI 1.6-2.0) for small for gestational age birth weight.
There is an increased risk of adverse infant outcomes in women who experience imprisonment compared with the general population, whether they are in prison during pregnancy or not.
描述经历监禁的妇女所生婴儿和产妇结局的人群风险，并将这些结局与一般人群进行比较。
我们进行了一项回顾性队列研究。我们使用了 2010 年从省级监狱获释的妇女的矫正和健康数据进行链接。我们为安大略省 2005 年至 2015 年的单胎分娩定义了三组暴露人群：在妊娠期间但不一定在分娩期间入狱的妇女所分娩的婴儿为监禁妊娠组；曾经入狱但未在怀孕期间入狱的妇女所分娩的婴儿为监禁对照组；一般人群分娩的婴儿为一般人群组。我们使用广义估计方程比较了这些组。主要结局是早产、低出生体重和小于胎龄体重。次要结局包括新生儿重症监护病房（NICU）入院、新生儿戒断综合征、胎盘早剥和早产胎膜早破。
在监禁妊娠组（n=544）和监禁对照组（n=2156）中，早产风险分别为 15.5%和 12.5%，低出生体重风险分别为 13.0%和 11.6%，小于胎龄体重风险分别为 18.1%和 19.2%。与一般人群分娩（n=1284949）相比，调整了产妇年龄和产次后，监禁妊娠组和监禁对照组的比值比分别为 2.7（95%CI 2.2-3.4）和 2.1（95%CI 1.9-2.4），早产风险增加；分别为 3.1（95%CI 2.4-3.9）和 2.7（95%CI 2.3-3.1），低出生体重风险增加；分别为 1.6（95%CI 1.3-2.1）和 1.8（95%CI 1.6-2.0），小于胎龄体重风险增加。
与一般人群相比，经历监禁的妇女的婴儿不良结局风险增加，无论她们在怀孕期间是否在监狱中。
