Journal
PAEDIATRIC AND PERINATAL EPIDEMIOLOGY
Volume 29, Issue 1, Pages 31-40Publisher
WILEY
DOI: 10.1111/ppe.12162
Keywords
pregnancy in adolescence; maternal age; low birthweight infant; preterm birth; socio-economic factors
Funding
- Wellcome Trust Initiative
- International Development Research Center
- World Health Organization
- Overseas Development Administration
- European Union
- National Support Program for Centers of Excellence (PRONEX)
- Brazilian National Research Council (CNPq)
- Brazilian Ministry of Health
- Child Pastorate of Brazil
- UK Medical Research Council [MC_UU_12013/6]
- Wellcome Trust [092731]
- University of Bristol
- NIHR Senior Investigator Award [NF-SI-0611-10196]
- Medical Research Council [MC_UU_12013/5, MC_PC_15018, MC_UU_12013/6] Funding Source: researchfish
- MRC [MC_UU_12013/5, MC_UU_12013/6] Funding Source: UKRI
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BackgroundWe examined the associations of maternal age with low birthweight (LBW) and preterm birth in four cohorts from a middle- and a high-income country, where the patterning of maternal age by socio-economic position (SEP) is likely to differ. MethodsPopulation-based birth cohort studies were carried out in the city of Pelotas, Brazil in 1982, 1993, and 2004, and in Avon, UK in 1991 [Avon Longitudinal Study of Parents and Children (ALSPAC)]. Adjustment for multiple indicators of SEP were applied. ResultsLow SEP was associated with younger age at childbearing in all cohorts, but the magnitudes of these associations were stronger in ALSPAC. Inverse associations of SEP with LBW and preterm birth were observed in all cohorts. U-shaped associations were observed between maternal age and odds of LBW in all cohorts. After adjustment for SEP, increased odds of LBW for young mothers (<20 years) attenuated to the null but remained or increased for older mothers (35 years). Very young (<16 years) maternal age was also associated with both outcomes even after full SEP adjustment. SEP adjusted odds ratio of having a LBW infant in women <16 years and 35 years, compared with 25-29 years, were 1.48 [95% confidence interval (CI) 1.00, 2.20] and 1.66 [95% CI 1.36, 2.02], respectively. The corresponding results for preterm birth were 1.80 [95% CI 1.23, 2.64)] and 1.38 [95% CI 1.15, 1.67], respectively. ConclusionConfounding by SEP explains much of the excess risk of LBW and preterm among babies born to teenage mothers as a whole, but not for mothers aged <16 or 35 years. Given that the proportion of women becoming pregnant at <16 years is smaller than for those 35 years, the population burden is greater for older age.
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