The Impact of Early Age at First Childbirth on Maternal and Infant Health

• Type of Material: Article
• Authors: Cassandra M. Gibbs, Emory University; Amanda Wendt, Emory University; Stacey Peters, Emory University; Carol J Hogue, Emory University
• Language: English
• Date: 2012-07-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Blackwell Publishing Ltd.
• Final Published Version (URL): http://dx.doi.org/10.1111/j.1365-3016.2012.01290.x
• Title of Journal or Parent Work: Paediatric and Perinatal Epidemiology
• ISSN: 0269-5022
• Volume: 26
• Issue: SUPPL. 1
• Start Page: 259
• End Page: 284
• Keywords: INCREASED RISK; Obstetrics & Gynecology; ADOLESCENT PREGNANCY; PRETERM BIRTH; ADULT WOMEN; premature; ADVERSE BIRTH OUTCOMES; neonatal mortality; maternal mortality; low birthweight; TEENAGE PREGNANCIES; WEIGHT-GAIN; YOUNG ADOLESCENTS; Public, Environmental & Occupational Health; adolescent pregnancy; Pediatrics; neonatal death; Science & Technology; preterm; RURAL NEPAL; POPULATION; still birth; maternal morbidity; maternal nutritional status; Life Sciences & Biomedicine; Age at first pregnancy
• Research Categories: Health Sciences, Obstetrics and Gynecology

Abstract

The objective of this review was to assess whether early age at first childbirth is associated with increased risk of poor pregnancy outcomes. Early age at childbirth is variously defined in studies of its effect on maternal and infant health. In this systematic review, we limit analysis to studies of at least moderate quality that examine first births among young mothers, where young maternal age is defined as low gynaecological age (≤2 years since menarche) or as a chronological age a;circ16 years at conception or delivery. We conduct meta-analyses for specific maternal or infant health outcomes when there are at least three moderate quality studies that define the exposure and outcome in a similar manner and provide odds ratios or risk ratios as their effect estimates. We conclude that the overall evidence of effect for very young maternal age (<15 years or <2 years post-menarche) on infant outcomes is moderate; that is, future studies are likely to refine the estimate of effect or precision but not to change the conclusion. Evidence points to an impact of young maternal age on low birthweight and preterm birth, which may mediate other infant outcomes such as neonatal mortality. The evidence that young maternal age increases risk for maternal anaemia is also fairly strong, although information on other nutritional outcomes and maternal morbidity/mortality is less clear. Many of the differences observed among older teenagers with respect to infant outcomes may be because of socio-economic or behavioural differences, although these may vary by country/setting. Future, high quality observational studies in low income settings are recommended in order to address the question of generalisability of evidence. In particular, studies in low income countries need to consider low gynaecological age, rather than simply chronological age, as an exposure. As well, country-specific studies should measure the minimum age at which childbearing for teens has similar associations with health as childbearing for adults. This 'tipping point' may vary by the underlying physical and nutritional health of girls and young women.