P0219 - Association of Parental Incarceration and Juvenile Justice Involvement with Pregnancy and Neonatal Outcomes

Background: Parental incarceration (PI) and juvenile justice involvement (JJI) are associated with worse physical and mental health outcomes throughout the life course. Both PI and JJI have been associated with increased risk of depression, anxiety, and substance use. PI has also been associated with worse health behaviors, health outcomes, and health care utilization. However, the influence of justice exposure in early life on subsequent pregnancy and neonatal outcomes remains unexplored.

Objective: To determine the relationship between an individual’s justice exposure (PI and JJI) during childhood, and their outcomes during pregnancy, as well as their children’s neonatal outcomes.

Methods: We analyzed the National Longitudinal Survey of Adolescent to Adult Health (Add Health) to examine the relationship between justice exposure before age 18 (i.e., parental incarceration and juvenile justice involvement) with subsequent pregnancy and neonatal outcomes in Wave IV of data. Multivariable logistic regression models controlled for individual (e.g., sex, race/ethnicity, education, receipt of public assistance) and geographic (i.e., urban suburban, rural, or other) characteristics and generated adjusted odds ratios (aORs).

Findings: The cohort included 13,083 young adults aged 24-34 years old: 14% had a history of parental incarceration and 3.6% had a history of juvenile justice involvement. PI exposure was associated with smoking (aOR=1.61 [95% CI, 1.16-2.24]) and drinking alcohol (aOR= 2.31 [95% CI, 1.34-3.96]) during pregnancy. JJI exposure was associated with smoking during pregnancy (aOR=7.75 [95% CI, 2.70-22.29]) and late prenatal care (aOR =7.25 [95% CI, 4.27-12.33]). JJI was also associated with premature birth (aOR=1.58 [95%CI, 1.19-2.09]) and birthweight less than six pounds (aOR= 0.36 [95% CI, 0.16-0.81]). PI and JJI were not associated with mode of delivery (i.e., c-section or vaginal).

Interpretation: Incarceration exposure influences the health of families for multiple generations. Both PI and JJI are associated with high-risk behaviors during pregnancy and JJI is associated with premature birth and low birth weight. Furthermore, given the disproportionate impact of incarceration on racial and ethnic minorities, incarceration has implications for health disparities and both maternal and infant mortality. Assessing childhood exposure to incarceration during pregnancy could provide a critical window to prevent and address adverse health conditions downstream for both mother and baby.