Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 3° Piso, 96020-220, Pelotas, Brazil.
BMC Public Health. 2011 Oct 10;11:781. doi: 10.1186/1471-2458-11-781.
The role of young maternal age as a determinant of adverse child health outcomes is controversial, with existing studies providing conflicting results. This work assessed the association between adolescent childbearing and early offspring mortality in three birth cohort studies from the city of Pelotas in Southern Brazil.
All hospital births from 1982 (6,011), 1993 (5,304), and 2004 (4,287) were identified and these infants were followed up. Deaths were monitored through vital registration, visits to hospitals and cemeteries. The analyses were restricted to women younger than 30 years who delivered singletons (72%, 70% and 67% of the original cohorts, respectively). Maternal age was categorized into three groups (< 16, 16-19, and 20-29 years). Further analyses compared mothers aged 12-19 and 20-29 years. The outcome variables included fetal, perinatal, neonatal, postneonatal and infant mortality. Crude and adjusted odds ratios (ORs) were estimated with logistic regression models.
There were no interactions between maternal age and cohort year. After adjustment for confounding, pooled ORs for mothers aged 12-19 years were 0.6 (95% CI = 0.4; 1.0) for fetal death, 0.9 (0.6; 1.3) for perinatal death, 1.0 (0.7; 1.6) for early neonatal death, 1.6 (0.7; 3.4) for late neonatal death, 1.8 (1.1; 2.9) for postneonatal death, and 1.6 (1.2; 2.1) for infant death, when compared to mothers aged 20-29 years. Further adjustment for mediating variables led to the disappearance of the excess of postneonatal mortality. The number of mothers younger than 16 years was not sufficient for most analyses.
The slightly increased odds of postneonatal mortality among children of adolescent mothers suggest that social and environmental factors may be more important than maternal biologic immaturity.
年轻母亲年龄作为不良儿童健康结果的决定因素的作用存在争议，现有研究结果相互矛盾。本项工作评估了在巴西南部城市佩洛塔斯的三项出生队列研究中，青少年生育与早期后代死亡之间的关联。
确定了 1982 年（6011 例）、1993 年（5304 例）和 2004 年（4287 例）的所有医院分娩，并对这些婴儿进行了随访。通过人口登记、医院和墓地的访问来监测死亡情况。分析仅限于年龄小于 30 岁且分娩单胎的女性（分别为原始队列的 72%、70%和 67%）。将母亲的年龄分为三组（<16 岁、16-19 岁和 20-29 岁）。进一步的分析比较了 12-19 岁和 20-29 岁的母亲。结局变量包括胎儿、围产儿、新生儿、晚期新生儿和婴儿死亡率。使用逻辑回归模型估计了粗和调整后的比值比（OR）。
母亲年龄与队列年份之间没有相互作用。在校正混杂因素后，年龄在 12-19 岁的母亲的合并 OR 分别为胎儿死亡 0.6（95%CI=0.4；1.0）、围产儿死亡 0.9（0.6；1.3）、早期新生儿死亡 1.0（0.7；1.6）、晚期新生儿死亡 1.6（0.7；3.4）、晚期新生儿死亡 1.8（1.1；2.9）、婴儿死亡 1.6（1.2；2.1），与 20-29 岁的母亲相比。进一步调整中介变量导致新生儿晚期死亡的超额风险消失。年龄小于 16 岁的母亲人数不足以进行大多数分析。
青少年母亲的后代新生儿后期死亡的几率略有增加，这表明社会和环境因素可能比母亲的生物不成熟更为重要。
