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Perinatal health care services for imprisoned pregnant women and associated outcomes: a systematic review

Perinatal health care services for imprisoned pregnant women and associated outcomes: a systematic review
Perinatal health care services for imprisoned pregnant women and associated outcomes: a systematic review

Background: women are an increasing minority of prisoners worldwide, and most are of childbearing age. Prisons offer unique opportunities for improving the pregnancy outcomes of these high-risk women, and no systematic review to date has looked at their care. This systematic review identified studies describing models of perinatal health care for imprisoned women which report maternal and child health and care outcomes.

Methods: we systematically searched for literature published between 1980 and April 2014. Studies were eligible if they included a group of imprisoned pregnant women, a description of perinatal health care and any maternal or infant health or care outcomes. Two authors independently extracted data. We described relevant outcomes in prisons (including jails) under models of care we termed PRISON, PRISON+ and PRISON++, depending on the care provided. Where outcomes were available on a comparison group of women, we calculated odds ratios with 95 % confidence intervals.

Results: eighteen studies were reported, comprising 2001 imprisoned pregnant women. Fifteen were in the US, two in the UK and one in Germany. Nine contained a comparison group of women comprising 849 pregnant women. Study quality was variable and outcome reporting was inconsistent. There was some evidence that women in prisons receiving enhanced prison care, PRISON+, were less likely to have inadequate prenatal care (15.4 % vs 30.7 %, p < 0 · 001), preterm delivery (6.4 % vs 19.0 %, p = 0 · 001) or caesarean delivery (12.9 % vs 26.5 %, p = 0 · 005) compared to women in prisons receiving usual care (PRISON). Women participating in two PRISON++ interventions, that is, interventions which included not only enhanced care in prisons but also coordination of community care on release, demonstrated reductions in long term recidivism rates (summary OR 0 · 37, 95 % CI 0 · 19-0 · 70) compared to pregnant women in the same prisons who did not participate in the intervention.

Conclusions: enhanced perinatal care can improve both short and long-term outcomes but there is a lack of data. Properly designed programmes with rigorous evaluation are needed to address the needs of this vulnerable population. The cost to mothers, children and to society of failing to address these important public health issues are likely to be substantial.

Trial registration: PROSPERO registration: CRD42012002384 .

1471-2393
Bard, Eleanor
ed11e53d-a311-4e21-ae06-bb01bbf6f3b9
Knight, Marian
85aa1323-352b-431c-8fd2-e4902f6e8dc0
Plugge, Emma
b64d2086-6cf2-4fae-98bf-6aafa3115b35
Bard, Eleanor
ed11e53d-a311-4e21-ae06-bb01bbf6f3b9
Knight, Marian
85aa1323-352b-431c-8fd2-e4902f6e8dc0
Plugge, Emma
b64d2086-6cf2-4fae-98bf-6aafa3115b35

Bard, Eleanor, Knight, Marian and Plugge, Emma (2016) Perinatal health care services for imprisoned pregnant women and associated outcomes: a systematic review. BMC Pregnancy and Childbirth, 16, [285]. (doi:10.1186/s12884-016-1080-z).

Record type: Article

Abstract

Background: women are an increasing minority of prisoners worldwide, and most are of childbearing age. Prisons offer unique opportunities for improving the pregnancy outcomes of these high-risk women, and no systematic review to date has looked at their care. This systematic review identified studies describing models of perinatal health care for imprisoned women which report maternal and child health and care outcomes.

Methods: we systematically searched for literature published between 1980 and April 2014. Studies were eligible if they included a group of imprisoned pregnant women, a description of perinatal health care and any maternal or infant health or care outcomes. Two authors independently extracted data. We described relevant outcomes in prisons (including jails) under models of care we termed PRISON, PRISON+ and PRISON++, depending on the care provided. Where outcomes were available on a comparison group of women, we calculated odds ratios with 95 % confidence intervals.

Results: eighteen studies were reported, comprising 2001 imprisoned pregnant women. Fifteen were in the US, two in the UK and one in Germany. Nine contained a comparison group of women comprising 849 pregnant women. Study quality was variable and outcome reporting was inconsistent. There was some evidence that women in prisons receiving enhanced prison care, PRISON+, were less likely to have inadequate prenatal care (15.4 % vs 30.7 %, p < 0 · 001), preterm delivery (6.4 % vs 19.0 %, p = 0 · 001) or caesarean delivery (12.9 % vs 26.5 %, p = 0 · 005) compared to women in prisons receiving usual care (PRISON). Women participating in two PRISON++ interventions, that is, interventions which included not only enhanced care in prisons but also coordination of community care on release, demonstrated reductions in long term recidivism rates (summary OR 0 · 37, 95 % CI 0 · 19-0 · 70) compared to pregnant women in the same prisons who did not participate in the intervention.

Conclusions: enhanced perinatal care can improve both short and long-term outcomes but there is a lack of data. Properly designed programmes with rigorous evaluation are needed to address the needs of this vulnerable population. The cost to mothers, children and to society of failing to address these important public health issues are likely to be substantial.

Trial registration: PROSPERO registration: CRD42012002384 .

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Accepted/In Press date: 20 September 2016
e-pub ahead of print date: 29 September 2016

Identifiers

Local EPrints ID: 485239
URI: http://eprints.soton.ac.uk/id/eprint/485239
ISSN: 1471-2393
PURE UUID: 948bcca5-250a-4e0e-b4ba-75e312e91a82
ORCID for Emma Plugge: ORCID iD orcid.org/0000-0002-8359-0071

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Date deposited: 01 Dec 2023 17:46
Last modified: 12 Jul 2024 02:06

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Contributors

Author: Eleanor Bard
Author: Marian Knight
Author: Emma Plugge ORCID iD

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