Young maternal age and infant mortality: the role of low birth weight.

In 1980, there were 562,330 babies born in the United States to teenage mothers (19 years of age or younger). The offspring of teenage mothers have long been known to be at increased risk of infant mortality, largely because of their high prevalence of low birth weight (less than 2,500 grams). We used data from the National Infant Mortality Surveillance (NIMS) project to examine the effect of young maternal age and low birth weight on infant mortality among infants born in 1980 to U.S. residents. This analysis was restricted to single-delivery babies who were either black or white, who were born to mothers ages 10-29 years, and who were born in one of 48 States or the District of Columbia. Included were 2,527,813 births and 28,499 deaths (data from Maine and Texas were excluded for technical reasons). Direct standardization was used to calculate the relative risks, adjusted for birth weight, of neonatal mortality (less than 28 days of life) and postneonatal mortality (28 days to less than 1 year of life) by race and maternal age. There was a strong association between young maternal age and high infant mortality and between young maternal age and a high prevalence of low birth weight. Neonatal mortality declined steadily with increasing maternal age. After adjusting for birth weight, the race-specific relative risks for babies born to mothers less than 16 years of age were still elevated from 11 to 40 percent, compared with babies born to mothers 25-29 years of age. Otherwise, all the relative risks were nearly equal to 1. By contrast, most of the association between young maternal age and postneonatal mortality persisted after birth weight adjustment in all maternal age groups.These results suggest that the prevention of neonatal mortality and, to a lesser extent, postneonatal mortality among babies born to teenagers depends on preventing low birth weight. The prevention of postneonatal mortality may depend more on other factors, such as assisting teenagers with better parenting. Finally, although there maybe few biological reasons to postpone childbearing,teenage childbearing continues to place the mother and her baby at a social disadvantage.