Pregnancy, Crime, and Birth Outcomes
BACKGROUND There is a well-documented association between elevated maternal stress and the risk of adverse birth outcomes. This stress is caused by both biological and societal conditions, including poverty, racial discrimination, and lack of access to quality health care. Less examined is the impact of criminal justice involvement on these outcomes. This study aims to explore the relationship between maternal criminal justice involvement and poor birth outcomes. METHODS This is a secondary analysis of three existing databases: (1) Charging requests, (2) birth certificates, and (3) linked birth-death records. Criminal justice data included all Kalamazoo County charging requests, 2007-2010, involving a named victim. The Michigan Department of Community Health Vital Records birth and linked birth-death datasets consisted of all births within Kalamazoo County, 2008-2009, and any infant deaths (0 to age 1) occurring among this population. The birth dataset included information regarding maternal demographics, health risks and birth outcomes. The data were matched using Link Plus, a standalone, probabilistic record linkage program, using personal identifiers. Women delivering 2008-2009 constituted the study sample (N=6,217). Logistic regression was conducted, predicting the association of maternal crime-involvement with infant health (premature delivery, low birthweight or death within the first year). RESULTS In total, 6.1% of all women giving birth were crime-involved the years before, during, or after pregnancy. They were nearly twice as likely to be a victim as a perpetrator (4.9% vs 2.6%). The rate of victimization increased over time from 1.8% in the year prior to the pregnancy to 2.8% the year after. Maternal criminal involvement was significantly associated with poverty (Wald Chi Square 152.993, p<.001) and prenatal smoking (Wald Chi Square 27.209, p<.001). After controlling for these variables, maternal criminal justice involvement during the perinatal period was a significant predictor of poor birth outcomes (Wald Chi Square 10.609, p=.001). The type of criminal involvement (whether as a victim, a perpetrator or both) did not have a significant impact upon birth outcome (Wald Chi Square 0.679, p=.410). CONCLUSIONS Maternal crime involvement is a significant and independent predictor of poor infant health. While additional research is warranted to further explore this relationship, our data have identified a potential upstream point at which at-risk individuals can be identified and connected to resources to improve birth outcomes and subsequent infant health.