2 4 Many of these health, social and psychological difficulties are related to the reasons for the child entering the care system. Sixty-two per cent of these children entered the care system due to abuse or neglect, and for 3% of looked-after Tofacitinib alopecia children, their own health problems led to them entering into care.2 It
is likely that these disadvantages continue into adult life for many of these children.5 Despite these health and social disadvantages, there is very little evidence on the health status of this group. They are an under-represented group in research as they are a highly mobile group, with issues of parental consent making enrolment into research studies difficult.6 Few studies have used nationally representative samples focusing on health outcomes over the life course of children who have been in care.1 4 5 Even fewer have investigated outcomes during pregnancy and early motherhood.7
In particular, whether mothers with a history of time spent in care have adverse maternal and pregnancy outcomes is currently unknown. Pregnancy and early motherhood is an important stage in the life cycle: a time when women have a high level of contact with health and social care services. As a consequence, there is potential to identify high-risk women and provide interventions to improve pregnancy outcomes.8 This may be particularly relevant to adults who have previously been in care and who may have had a reduction in residential stability leading to disjointed health service access and reduced exposure to health advice and information. Measures have been proposed to improve outcomes for socially disadvantaged women such as multiagency working, tailored antenatal services, community-based continuity of care schemes and Family Nurse Partnerships for young mothers.9 10 Although
previous work has looked at the associations between sexual risk behaviours Brefeldin_A and a history of time in care, very little evidence is available on the health status and maternal outcomes of these women. Previous research has shown that girls who have been in care have worse sexual health outcomes than girls who have never been in care. Girls who have been in care have a greater risk of teenage pregnancy, an earlier age at first intercourse and an increased number of sexual partners compared to girls who had not spent any time in the care system.11–15 In addition to a higher risk of teenage pregnancy and an increased number of sexual partners, Hobcraft15 found that girls who had been in care were at an increased risk of factors relating to social exclusion, such as no qualifications, homelessness and poor-quality housing.
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