McCormick M C, Shapiro S, Starfield B
Am J Public Health. 1984 Jan;74(1):18-23. doi: 10.2105/ajph.74.1.18.
An examination of the changes in infant mortality and morbidity in four regions in the United States has revealed high levels of health problems among the infants of two groups of mothers: those less than or equal to 17 years and 18-19 year-old multiparas, many of whom began their childbearing under age 18. Despite decreases over the period of observation, neonatal mortality rates remain over one and a half times as high for infants of these mothers as for other mothers, largely due to the relatively high proportion of low birthweight (LBW) infants born to these mothers. Post-neonatal mortality rates also remain high, and may be increasing; this change cannot be explained solely by differences in proportion of LBW infants between these and older mothers. Both the high post-neonatal mortality rates and the type of morbidity experienced by surviving infants is consistent with the socioeconomic disadvantage of young mothers. The data further indicate the limited resources available to these mothers to cope with their children's health needs, and their potential vulnerability to decreases in public programs supporting child health care.
对美国四个地区婴儿死亡率和发病率变化的一项调查显示,两组母亲的婴儿存在高度的健康问题:年龄小于或等于17岁的母亲以及18 - 19岁的经产妇,其中许多人在18岁之前就开始生育。尽管在观察期内有所下降,但这些母亲所生婴儿的新生儿死亡率仍比其他母亲所生婴儿高出一倍半以上,这主要是因为这些母亲所生低体重婴儿的比例相对较高。新生儿后期死亡率也居高不下,而且可能还在上升;这种变化不能仅仅用这些母亲与年龄较大母亲所生低体重婴儿比例的差异来解释。新生儿后期的高死亡率以及存活婴儿所经历的发病类型都与年轻母亲的社会经济劣势相符。数据进一步表明,这些母亲可用于应对孩子健康需求的资源有限,而且她们很可能因支持儿童医疗保健的公共项目减少而变得脆弱。