Characteristics and birth outcomes of pregnant adolescents compared to older women: An analysis of individual level data from 140,000 mothers from 20 RCTs

EClinicalMedicine

Emily Catherine Keats¹  Pravheen Thurairajah¹  Zulfiqar Ahmed Bhutta¹  Nadia Akseer¹  Ulla Ashorn²  Patrick Wilfried Kolsteren³  Faruk Ahmed⁴  Wafaie Fawzi⁵  Shams El Arifeen⁶  David Osrin⁷  Lieven Huybregts⁸  Keith West⁹  Parul Christian⁹  Robert E. Black⁹  Simon Cousens^1,10  Lingxia Zeng^1,11  Ellen Piwoz^1,12  Michael J. Dibley^1,13  José Belizán^1,14  Noel Zagre^1,15  Kathryn Dewey^1,16  Pernille Kaestel^1,17  Henrik Friis^1,17  Brietta M. Oaks^1,18  Exnevia Gomo^1,19  Ana Pilar Bétran^2,20 

[1] Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada;Faculty of Medicine and Health Technology, Tampere University, Finland;Ghent University, Belgium;Griffith University, Australia;Harvard T.H. Chan School of Public Health, United States;ICDDRB, Bangladesh;Institute for Global Health, University College London, United Kingdom;International Food Policy Research Institute, United States;Johns Hopkins Bloomberg School of Public Health, United States;London School of Hygiene and Tropical Medicine, London, United Kingdom;School of Public Health, Xi'an Jiaotong University Health Science Centre, China;The Bill and Melinda Gates Foundation, United States;The University of Sydney, Australia;UNC Chapel Hill, United States;UNICEF Regional Office for West and Central Africa, Senegal;University of California, Davis, United States;University of Copenhagen, Denmark;University of Rhode Island, United States;University of Zimbabwe, Zimbabwe;World Health Organization, Switzerland;

关键词: Adolescence;    Age;    Determinants;    Pregnancy;    Birth outcomes;   

DOI  :  

来源: DOAJ

【 摘 要 】

Summary:Background: Adolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10–19 years) compared to older mothers in low and middle-income countries. Methods: This study was conducted between March 16, 2018 and May 25, 2021. Data were obtained from 20 randomised controlled trials of micronutrient supplementation in pregnancy. Stratified analyses were conducted by age (10–14 years, 15–17 years, 18–19 years, 20–29 years, 30–39 years, 40+ years) and geographical region (Africa, Asia). Crude and confounder-adjusted means, prevalence and relative risks of pregnancy, nutrition and birth outcomes were estimated using multivariable linear and log-binomial regression models with 95% confidence intervals. Findings: Adolescent mothers comprised 31.6% of our data. Preterm birth, small-for-gestational age (SGA), low birthweight (LBW) and newborn mortality followed a U-shaped trend in which prevalence was highest among the youngest mothers (10–14 years) and then reduced gradually, but increased again for older mothers (40+ years). When compared to mothers aged 20–29 years, there was a 23% increased risk of preterm birth, a 60% increased risk of perinatal mortality, a 63% increased risk of neonatal mortality, a 28% increased risk of LBW, and a 22% increased risk of SGA among mothers 10–14 years. Mothers 40+ years experienced a 22% increased risk of preterm birth and a 103% increased risk of stillbirth when compared to the 20–29 year group. Interpretation: The youngest and oldest mothers suffer most from adverse pregnancy and birth outcomes. Policy and programming agendas should consider both biological and socioeconomic/environmental factors when targeting these populations. Funding: Bill and Melinda Gates Foundation (Grant No: OP1137750).

【 授权许可】

Unknown