School of Industrial Engineering, Purdue University, 315 N Grant St., West Lafayette, IN, 47906, USA.
School of Industrial and Systems Engineering, Georgia Institute of Technology, 755 Ferst Dr. NW, Atlanta, GA, 30332, USA.
Matern Child Health J. 2021 May;25(5):821-831. doi: 10.1007/s10995-020-03086-z. Epub 2020 Nov 20.
To assess the effect of adolescent birth on the health and wellness of these infants within their first year of life.
Our study focused on 2011 Medicaid births nationwide. The study group (infants born to adolescents, aged 10 to 19 at time of birth) was matched with infants born to adults (aged 20 to 44 at time of birth), based on demographics. Statistical tests (proportion test and Poisson test) were used to compare the outcomes of these two groups to determine if differences were significant.
The outcomes assessed were: low birth weight (LBW), substance exposure, foster care, health status, infant mortality, emergency department (ED) visits, and wellness visits. Of the 68,562 infant pairs included in the study, we found statistically significant higher rates of LBW (P ≤ 0·005), infant mortality (P = 0·05), and ED visits (P ≤ 0·005) for infants born to adolescents at the 95% confidence interval. The rate of wellness visits for all infants was well below the recommended amount. Additional differences were found at the race/ethnicity and urbanicity levels.
Infants born to adolescents had a higher rate of ED visits within the first year of life, however, the increased rates of LBW and mortality for the Medicaid population are not as significant as previous national studies suggest. Analysis of outcomes across stratification helped identify vulnerable populations (i.e. urban infants). Public health programs are urged to examine ED visits in infants born to adolescents among the Medicaid population. Improved health education or phone-based resources could help reduce unnecessary visits and reduce cost.
评估青少年生育对这些婴儿在生命的头一年的健康和健康状况的影响。
我们的研究集中在全国范围内的 2011 年医疗补助出生。研究组（青少年出生的婴儿，出生时年龄为 10 至 19 岁）根据人口统计学与成人（出生时年龄为 20 至 44 岁）出生的婴儿相匹配。使用统计检验（比例检验和泊松检验）比较这两组的结果，以确定差异是否显著。
评估的结果是：低出生体重（LBW）、物质暴露、寄养、健康状况、婴儿死亡率、急诊部（ED）就诊和健康检查。在纳入研究的 68562 对婴儿中，我们发现出生于青少年的婴儿 LBW（P≤0.005）、婴儿死亡率（P=0.05）和 ED 就诊率（P≤0.005）的统计学显著更高，置信区间为 95%。所有婴儿的健康检查率都远低于推荐量。在种族/族裔和城市水平也发现了其他差异。
在生命的头一年，出生于青少年的婴儿 ED 就诊率更高，然而，对于医疗补助人群，LBW 和死亡率的增加率并不像之前的全国性研究表明的那样显著。通过分层分析结果，帮助确定了弱势群体（即城市婴儿）。敦促公共卫生计划检查 Medicaid 人群中青少年生育的婴儿的 ED 就诊情况。改善健康教育或基于电话的资源可以帮助减少不必要的就诊次数并降低成本。
