Abstract Body: Background: Adverse childhood experiences (ACEs) are associated with adverse pregnancy outcomes (APOs). However, the association between specific ACEs, such as parental incarceration, with APOs is not well understood. We examined whether: (1) childhood parental incarceration and its duration are associated with APOs and (2) if the association differed by race and ethnicity.
Methods: Parous participants ≥ 18 years without: (1) history of CVD or diabetes and (2) did not have a pregnancy prior to age 18 in Wave V (2016-2018) of the US National Longitudinal Survey of Adolescent to Adult Health were analyzed. Childhood parental incarceration was defined as incarceration of the respondent’s parent/parental figure before age 18. Duration of parental incarceration was calculated by taking the difference of the age of respondents when the parent started and ended incarceration. Our outcome was defined as the self-reported occurrence of any APO (gestational diabetes, hypertensive disorder of pregnancy, small for gestational age, and pre-term birth). Multivariable logistic regression models assessed associations between parental incarceration and APOs. Covariates included age, difficulty paying bills, marital status, and smoking status during pregnancy. Models were stratified to assess interaction by race and ethnicity.
Results: Among 2,088 participants, 234 (11.2%) reported a history of parental incarceration. Women with a history of parental incarceration were younger at first pregnancy, disproportionately Black, more likely to struggle paying bills, and had a higher prevalence of APOs. In unadjusted models, women who experienced childhood parental incarceration had 45% increased odds of experiencing an APO (OR 1.45; 95% CI: 1.10-1.92) but was nonsignificant after adjustment (OR 1.16; 95% CI: 0.83-1.62). Duration of incarceration was not associated with occurrence of APOs though the association differed by race such that a one-year increase in duration of parental incarceration was associated with 6% increased odds of having an APO among Black women (OR 1.06; 95% CI: 1.001-1.12).
Conclusions: Longer duration of childhood parental incarceration was associated with higher odds of APOs for Black women. Future research should examine biological pathways by which parental incarceration contributes to deleterious health outcomes, particularly in minoritized communities.