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Author Notes:

Correspondence: Cassandra M. Gibbs, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA. cmgibbs@emory.edu

We would like to thank Vishwarupa Vasani for her assistance with article abstraction and Barbara Abu-Zeid for her assistance with crafting our database searches.

The authors declare no conflicts of interest in connection with this work.

Subject:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Public, Environmental & Occupational Health
  • Obstetrics & Gynecology
  • Pediatrics
  • Age at first pregnancy
  • adolescent pregnancy
  • maternal nutritional status
  • maternal morbidity
  • maternal mortality
  • preterm
  • premature
  • low birthweight
  • still birth
  • neonatal death
  • neonatal mortality
  • ADVERSE BIRTH OUTCOMES
  • ADOLESCENT PREGNANCY
  • YOUNG ADOLESCENTS
  • INCREASED RISK
  • PRETERM BIRTH
  • RURAL NEPAL
  • TEENAGE PREGNANCIES
  • WEIGHT-GAIN
  • ADULT WOMEN
  • POPULATION

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

Tools:

Journal Title:

Paediatric and Perinatal Epidemiology

Volume:

Volume 26, Number SUPPL. 1

Publisher:

, Pages 259-284

Type of Work:

Article | Post-print: After Peer Review

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.

Copyright information:

© 2012 Blackwell Publishing Ltd.

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