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Prenatal Care and Pregnancy Outcome Among Incarcerated Pregnant Individuals in the United States: A Systematic Review and Meta-Analysis Publisher Pubmed



Hessami K1 ; Hutchinsoncolas JA2 ; Chervenak FA3 ; Shamshirsaz AA1 ; Zargarzadeh N4 ; Norooznezhad AH4 ; Grunebaum A3 ; Bachmann GA2
Authors
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Authors Affiliations
  1. 1. Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
  2. 2. Department of Obstetrics and Gynecology, Women's Health Institute, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States
  3. 3. Departments of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, United States
  4. 4. Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Perinatal Medicine Published:2023


Abstract

This systematic review and meta-analysis assessed the risk of inadequate prenatal care and pregnancy outcome among incarcerated pregnant individuals in the United States. PubMed/MedLine, Embase, ClinicalTrials.gov and Web of Science were searched from inception up to March 30th, 2022. Studies were included if they reported the risk of inadequate prenatal care and/or pregnancy outcomes among incarcerated pregnant individuals in the United States jails or prisons. Adequacy of prenatal care was quantified by Kessner index. The random-effects model was used to pool the mean differences or odds ratios (OR) and the corresponding 95% confidence intervals (CIs) using RevMan software. Nine studies were included in the final review. A total of 11,534 pregnant individuals, of whom 2,544 were incarcerated while pregnant, and 8,990 who were matched non-incarcerated pregnant individuals serving as control group, were utilized. Compared to non-incarcerated pregnancies, incarcerated pregnant individuals were at higher risk of inadequate prenatal care (OR 2.99 [95% CI: 1.60, 5.61], p<0.001) and were more likely to have newborns with low birthweight (OR 1.66 [95% CI: 1.19, 2.32], p=0.003). There was no significant difference between incarcerated and matched control pregnancies in the rates of preterm birth and stillbirth. The findings of the current systematic review and meta-analysis suggest that incarcerated pregnant individuals have an increased risk of inadequate prenatal care. Considering the limited number of current studies, further research is indicated to both assess whether the risk of inadequate prenatal care has negative impact on prenatal outcomes for this population and to determine the steps that can be taken to enhance prenatal care for all pregnant individuals incarcerated in the United States prisons. © 2022 Walter de Gruyter GmbH, Berlin/Boston.
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