Zer Shiran, Wainstock Tamar, Walfisch Asnat, Sheiner Eyal
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Faculty of Health Sciences, Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
J Pediatr Adolesc Gynecol. 2019 Dec;32(6):622-627. doi: 10.1016/j.jpag.2019.08.003. Epub 2019 Aug 8.
To evaluate whether extremely young maternal age (≤17 years) is associated with an increased risk of adverse perinatal outcome and an increased risk for long-term pediatric morbidity in offspring. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A retrospective population-based cohort study, in which all singleton deliveries of women, between the years 1991 and 2014 were compared. Parturients were classified into 3 groups according to age at delivery: 17 years or younger, 18-20 years, and 21-35 years (the comparison group). The incidence of long-term hospitalizations of offspring because of cardiovascular, endocrine, hematological, and respiratory morbidity were evaluated in the 3 maternal age groups. Kaplan-Meier survival curves were used to compare the cumulative morbidity incidence. Multiple regression models were used to estimate the association between young maternal age and adverse pregnancy outcomes, and long-term offspring morbidities (using survival analysis) while controlling for multiple potential confounders.
Of 213,177 deliveries that met the inclusion criteria, 90.1% (n = 192,185) occurred in mothers aged 21-35 years, 8.7% (n = 18,645) in mothers 18-20 years old, and 2347 were in mothers aged 17 years or younger (1.1%). Using multivariable logistic regression models, low birth weight and preterm delivery were significantly associated with young maternal age. The incidence of long-term morbidities of the offspring did not differ between the groups, in either the Kaplan-Meier analysis or the multivariable survival analysis.
评估极年轻产妇年龄（≤17岁）是否与围产期不良结局风险增加以及后代长期儿科疾病发病率增加相关。设计、设置、参与者、干预措施及主要结局指标：一项基于人群的回顾性队列研究，比较1991年至2014年间所有单胎分娩的女性。根据分娩时年龄将产妇分为3组：17岁及以下、18 - 20岁和21 - 35岁（对照组）。评估3个产妇年龄组中后代因心血管、内分泌、血液和呼吸系统疾病导致的长期住院发生率。采用Kaplan - Meier生存曲线比较累积发病率。使用多元回归模型估计年轻产妇年龄与不良妊娠结局以及后代长期疾病（采用生存分析）之间的关联，同时控制多个潜在混杂因素。
在符合纳入标准的213,177例分娩中，90.1%（n = 192,185）发生在21 - 35岁的母亲中，8.7%（n = 18,645）发生在18 - 20岁的母亲中，2347例发生在17岁及以下的母亲中（1.1%）。使用多变量逻辑回归模型，低出生体重和早产与年轻产妇年龄显著相关。在Kaplan - Meier分析或多变量生存分析中，各年龄组后代的长期疾病发病率无差异。
