Birth Outcome in Incarcerated, High-risk Pregnant Women

Objective: To compare birth outcomes in incarcerated women with a recent history of drug use to those of nonincarcerated women in a methadone maintenance program.

Study Design: We retrospectively analyzed pregnancy outcome in 149 women who delivered at full term between 1993 and 1996. Thirty-one patients incarcerated during pregnancy (group 1) were compared with 47 patients enrolled in our methadone maintenance program (group 2) and with a control group of 71 randomly chosen patients (group 3). Drug use, age, parity, number of visits, infant birth weight, low birth weight and Apgar scores were compared.

Results: The methadone maintenance group had significantly fewer clinic visits. All the patients in groups 1 and 2 were cigarette smokers, whereas 12.5% of the control group smoked. Over 78% of incarcerated women admitted using drugs immediately prior to imprisonment as compared to 4.11% in group 3 and 100% in group 2 (P < .001). The three groups differed significantly with respect to infant birth weight (P < .001).

Conclusion: Cessation of drug use followed by adoption of a health-promoting lifestyle and adequate prenatal care of incarcerated women leads to an improvement in birth outcome. Furthermore, provision of prenatal care on site is a suitable alternative for the care of incarcerated pregnant women and eliminates the need to bring patients in chains to outside clinics.