{"title":"怀孕时被监禁的原住民生育父母的生育结果:来自加拿大马尼托巴省的关联行政数据研究。","authors":"","doi":"10.1016/j.whi.2024.06.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>In Canada, colonial policies have resulted in health inequities between First Nations and other Canadians. These policies contribute to overrepresentation of First Nations in the criminal legal system, where incarcerated people and their infants face elevated health risks. We investigated the association between prenatal incarceration and adverse birth outcomes among First Nations and other birthing parents in Manitoba, Canada.</p></div><div><h3>Methods</h3><p>Using linked whole-population administrative data, we identified all live births (2004–2017) in which the birthing parent (First Nations <em>n</em> = 1,449; other Manitoban <em>n</em> = 278) was prenatally incarcerated and compared them to birthing parents who were postnatally incarcerated (First Nations <em>n</em> = 5,290; other Manitoban <em>n</em> = 790) or not incarcerated (First Nations <em>n</em> = 19,950; other Manitoban <em>n</em> = 3,203). We used generalized linear models adjusted for measured confounders with propensity score weighting to calculate risk differences and 95% confidence intervals for adverse birth outcomes among those prenatally versus postnatally incarcerated in each group.</p></div><div><h3>Results</h3><p>Low birthweight births were more likely among First Nations birthing parents who were prenatally (vs. postnatally) incarcerated (risk difference 1.59, 95% CI [.79, 2.38]) but less likely among other Manitoban birthing parents (risk difference −2.33, 95% CI [−4.50, −.16]) who were prenatally (vs. postnatally) incarcerated. Among First Nations, prenatal incarceration was also associated with large-for-gestational-age births, low Apgar scores, and no breastfeeding (vs. postnatal incarceration), as well as preterm births (vs. no incarceration). Among other Manitobans, prenatal incarceration was also associated with small-for-gestational-age births, low Apgar scores, and no breastfeeding (vs. postnatal incarceration), as well as preterm births (vs. no incarceration).</p></div><div><h3>Conclusions</h3><p>The findings suggest that incarceration may contribute to intergenerational systems of oppression by compromising birth outcomes among First Nations and other birthing parents in Canada and underscore the need to both improve care for pregnant people who are incarcerated and invest in alternatives to incarceration.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 5","pages":"Pages 488-497"},"PeriodicalIF":2.8000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386724000483/pdfft?md5=d4b2ee895cdafd16c655bc5a6f4329b9&pid=1-s2.0-S1049386724000483-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Birth Outcomes Among First Nations Birthing Parents Incarcerated While Pregnant: A Linked Administrative Data Study From Manitoba, Canada\",\"authors\":\"\",\"doi\":\"10.1016/j.whi.2024.06.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>In Canada, colonial policies have resulted in health inequities between First Nations and other Canadians. These policies contribute to overrepresentation of First Nations in the criminal legal system, where incarcerated people and their infants face elevated health risks. We investigated the association between prenatal incarceration and adverse birth outcomes among First Nations and other birthing parents in Manitoba, Canada.</p></div><div><h3>Methods</h3><p>Using linked whole-population administrative data, we identified all live births (2004–2017) in which the birthing parent (First Nations <em>n</em> = 1,449; other Manitoban <em>n</em> = 278) was prenatally incarcerated and compared them to birthing parents who were postnatally incarcerated (First Nations <em>n</em> = 5,290; other Manitoban <em>n</em> = 790) or not incarcerated (First Nations <em>n</em> = 19,950; other Manitoban <em>n</em> = 3,203). We used generalized linear models adjusted for measured confounders with propensity score weighting to calculate risk differences and 95% confidence intervals for adverse birth outcomes among those prenatally versus postnatally incarcerated in each group.</p></div><div><h3>Results</h3><p>Low birthweight births were more likely among First Nations birthing parents who were prenatally (vs. postnatally) incarcerated (risk difference 1.59, 95% CI [.79, 2.38]) but less likely among other Manitoban birthing parents (risk difference −2.33, 95% CI [−4.50, −.16]) who were prenatally (vs. postnatally) incarcerated. Among First Nations, prenatal incarceration was also associated with large-for-gestational-age births, low Apgar scores, and no breastfeeding (vs. postnatal incarceration), as well as preterm births (vs. no incarceration). Among other Manitobans, prenatal incarceration was also associated with small-for-gestational-age births, low Apgar scores, and no breastfeeding (vs. postnatal incarceration), as well as preterm births (vs. no incarceration).</p></div><div><h3>Conclusions</h3><p>The findings suggest that incarceration may contribute to intergenerational systems of oppression by compromising birth outcomes among First Nations and other birthing parents in Canada and underscore the need to both improve care for pregnant people who are incarcerated and invest in alternatives to incarceration.</p></div>\",\"PeriodicalId\":48039,\"journal\":{\"name\":\"Womens Health Issues\",\"volume\":\"34 5\",\"pages\":\"Pages 488-497\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1049386724000483/pdfft?md5=d4b2ee895cdafd16c655bc5a6f4329b9&pid=1-s2.0-S1049386724000483-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Womens Health Issues\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1049386724000483\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Womens Health Issues","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1049386724000483","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
背景:在加拿大,殖民政策造成了原住民与其他加拿大人在健康方面的不平等。这些政策导致原住民在刑事法律系统中的比例过高,被监禁者及其婴儿面临着更高的健康风险。我们调查了加拿大马尼托巴省原住民和其他生育父母产前入狱与不良出生结果之间的关联:利用关联的全人口管理数据,我们确定了分娩父母(原住民 n = 1,449 人;其他马尼托巴人 n = 278 人)产前曾被监禁的所有活产婴儿(2004-2017 年),并将其与产后曾被监禁(原住民 n = 5,290 人;其他马尼托巴人 n = 790 人)或未被监禁(原住民 n = 19,950 人;其他马尼托巴人 n = 3,203 人)的分娩父母进行了比较。我们使用广义线性模型对测量的混杂因素进行调整,并采用倾向得分加权法计算各组产前和产后被监禁者不良出生结果的风险差异和 95% 的置信区间:在产前(与产后)被监禁的原住民生育父母中,低出生体重儿的发生率较高(风险差异为 1.59,95% CI [.79,2.38]),但在产前(与产后)被监禁的其他马尼托巴生育父母中,低出生体重儿的发生率较低(风险差异为-2.33,95% CI [-4.50,-.16])。在原住民中,产前入狱还与胎龄过大、Apgar 评分过低、未进行母乳喂养(与产后入狱相比)以及早产(与未入狱相比)有关。在其他马尼托巴人中,产前监禁也与小于胎龄新生儿、低Apgar评分、无母乳喂养(与产后监禁相比)以及早产(与无监禁相比)有关:研究结果表明,监禁可能会损害加拿大原住民和其他生育父母的分娩结果,从而助长世代相传的压迫制度,并强调有必要改善对被监禁孕妇的护理,同时投资于监禁的替代措施。
Birth Outcomes Among First Nations Birthing Parents Incarcerated While Pregnant: A Linked Administrative Data Study From Manitoba, Canada
Background
In Canada, colonial policies have resulted in health inequities between First Nations and other Canadians. These policies contribute to overrepresentation of First Nations in the criminal legal system, where incarcerated people and their infants face elevated health risks. We investigated the association between prenatal incarceration and adverse birth outcomes among First Nations and other birthing parents in Manitoba, Canada.
Methods
Using linked whole-population administrative data, we identified all live births (2004–2017) in which the birthing parent (First Nations n = 1,449; other Manitoban n = 278) was prenatally incarcerated and compared them to birthing parents who were postnatally incarcerated (First Nations n = 5,290; other Manitoban n = 790) or not incarcerated (First Nations n = 19,950; other Manitoban n = 3,203). We used generalized linear models adjusted for measured confounders with propensity score weighting to calculate risk differences and 95% confidence intervals for adverse birth outcomes among those prenatally versus postnatally incarcerated in each group.
Results
Low birthweight births were more likely among First Nations birthing parents who were prenatally (vs. postnatally) incarcerated (risk difference 1.59, 95% CI [.79, 2.38]) but less likely among other Manitoban birthing parents (risk difference −2.33, 95% CI [−4.50, −.16]) who were prenatally (vs. postnatally) incarcerated. Among First Nations, prenatal incarceration was also associated with large-for-gestational-age births, low Apgar scores, and no breastfeeding (vs. postnatal incarceration), as well as preterm births (vs. no incarceration). Among other Manitobans, prenatal incarceration was also associated with small-for-gestational-age births, low Apgar scores, and no breastfeeding (vs. postnatal incarceration), as well as preterm births (vs. no incarceration).
Conclusions
The findings suggest that incarceration may contribute to intergenerational systems of oppression by compromising birth outcomes among First Nations and other birthing parents in Canada and underscore the need to both improve care for pregnant people who are incarcerated and invest in alternatives to incarceration.
期刊介绍:
Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.