Young maternal age and the risk of neonatal mortality in rural nepal

Authors

Vandana Sharma, Johns Hopkins Bloomberg School of Public Health
Joanne Katz, Johns Hopkins Bloomberg School of Public Health
Luke C. Mullany, Johns Hopkins Bloomberg School of Public Health
Subarna K. Khatry, Nepal Nutrition Intervention Project-Sarlahi
Steven C. LeClerq, Johns Hopkins Bloomberg School of Public Health
Sharada R. Shrestha, Nepal Nutrition Intervention Project-Sarlahi
Gary L. Darmstadt, Johns Hopkins Bloomberg School of Public Health
James M. Tielsch, Johns Hopkins Bloomberg School of Public HealthFollow

Document Type

Journal Article

Publication Date

9-1-2008

Journal

Archives of Pediatrics and Adolescent Medicine

Volume

162

Issue

9

DOI

10.1001/archpedi.162.9.828

Abstract

Objectives: To investigate the relationship between adolescent pregnancy and neonatal mortality in a nutritionally deprived population in rural Nepal, and to determine mechanisms through which low maternal age may affect neonatal mortality. Design: Nested cohort study using data from a population-based, cluster-randomized, placebo-controlled trial of newborn skin and umbilical cord cleansing with chlorhexidine. Setting: Sarlahi District of Nepal. Participants: Live-born singleton infants of mothers younger than 25 years who were either parity 0 or 1 (n=10 745). Main Exposure: Maternal age at birth of offspring. Outcome Measure: Crude and adjusted odds ratios of neonatal mortality by maternal age category. Results: Infants born to mothers aged 12 to 15 years were at a higher risk of neonatal mortality than those born to women aged 20 to 24 years (odds ratio,2.24; 95% confidence interval, 1.40-3.59). After adjustment for confounders, there was a 53% excess risk of neonatal mortality among infants born to mothers in the youngest vs oldest age category (1.53; 0.90-2.60). This association was attenuated on further adjustment for low birth weight, preterm birth, or small-for-gestational-age births. Conclusions: The higher risk of neonatal mortality among younger mothers in this setting is partially explained by differences in socioeconomic factors in younger vs older mothers; risk is mediated primarily through preterm delivery, low birth weight, newborns being small for gestational age, and/or some interaction of these variables. Trial Registration: clinicaltrials.gov Identifier: NCT00109616. ©2008 American Medical Association. All rights reserved.

APA Citation

Sharma, V., Katz, J., Mullany, L., Khatry, S., LeClerq, S., Shrestha, S., Darmstadt, G., & Tielsch, J. (2008). Young maternal age and the risk of neonatal mortality in rural nepal. Archives of Pediatrics and Adolescent Medicine, 162 (9). http://dx.doi.org/10.1001/archpedi.162.9.828