Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Birth. 2021 Mar;48(1):122-131. doi: 10.1111/birt.12524. Epub 2020 Dec 27.
In the United States, the population of incarcerated women has increased by more than 600% since the 1980s. With this rise, correctional facilities have faced new challenges meeting the health care needs of women, especially those who are pregnant. This retrospective cohort study sought to describe five indicators of maternal and neonatal health among women who gave birth in custody, and to compare outcomes among incarcerated women who did and did not receive enhanced pregnancy support.
We used deidentified electronic health records (EHRs) to examine maternal and neonatal birth outcomes (ie, mode of birth, low birthweight, preterm birth, APGAR score, NICU admission) among women who gave birth in custody. Regression models examined differences in outcomes between women who received enhanced pregnancy support-group prenatal education and one-on-one doula visits-and a historical control group of women who received standard prenatal care.
Adverse maternal and neonatal birth outcomes in this sample were rare. No differences in outcomes were found between incarcerated women who received enhanced pregnancy support and the historical control group.
Despite evidence for the benefits of enhanced pregnancy support in the general population, this study did not find differences in outcomes between incarcerated women who did and did not receive support. Integrated data from prison and hospital records are innovative, but effect measurement is limited by sample size. Future research should include primary data collection on maternal, neonatal, and dyadic outcomes longitudinally and across prisons.
自 20 世纪 80 年代以来，美国被监禁女性的数量增加了 600%以上。随着这一增长，惩教设施在满足女性，尤其是孕妇的医疗需求方面面临新的挑战。这项回顾性队列研究旨在描述被监禁女性分娩时母婴健康的五个指标，并比较接受和未接受强化妊娠支持的被监禁女性的结果。
我们使用去标识电子健康记录（EHR）来检查被监禁女性分娩时的母婴出生结局（即分娩方式、低出生体重、早产、阿普加评分、新生儿重症监护病房入院）。回归模型检查了接受强化妊娠支持组-产前教育和一对一导乐服务的女性与接受标准产前护理的历史对照组女性之间结局的差异。
在该样本中，不良母婴出生结局很少见。接受强化妊娠支持的被监禁女性与历史对照组之间在结局上没有差异。
尽管强化妊娠支持在一般人群中的益处有证据支持，但本研究未发现接受和未接受支持的被监禁女性之间在结局上有差异。从监狱和医院记录综合数据是创新的，但由于样本量有限，效果测量受到限制。未来的研究应包括对母婴和对偶结局进行纵向和跨监狱的前瞻性数据收集。
