The risk for infant mortality among adolescent childbearing groups.
OBJECTIVE
To evaluate risk disparities and risk factors for infant mortality among adolescent childbearing age groups.


METHODS
We combined the 1995 and 1996 comprehensive U.S. birth cohorts provided by the National Center for Heath Statistics. Our analysis included 777,762 singleton, first births to women aged 12-19 years linked to 4631 infant deaths. We used both bivariate comparisons and multivariable logistic regression for our analysis, with infant mortality as our main outcome measure.


RESULTS
Rates of infant mortality are substantially higher for < or =15-year-olds (8.1/1000 live births) compared with 16-17-year-olds (6.3/1000 live births) and 18-19-year-olds (5.4/1000 live births). Even after adjusting for risk factors associated with poor outcomes, including alcohol use, tobacco use, and prenatal care use, the risk for infant mortality was 1.6 (95% confidence interval [95% CI] 1.4, 1.7) times greater for infants of mothers < or =15 years old as compared with those mothers 18-19 years old. In the < or =15-year-old group, 62% of fathers were not reported on the child's birth certificate. Not reporting the father was associated with a 24% increased risk for infant mortality after adjusting for maternal and infant risk factors.


CONCLUSIONS
Childbearing in < or =15-year-olds is associated with a substantial increased risk for infant mortality compared with childbearing in older adolescence. This study suggests that not reporting the father on a birth certificate is a potential risk marker. Risk differences among adolescent age groups may be important to consider when creating tailored intervention and prevention strategies.
Phipps
Maureen G
MG
Brown Medical School, Women & Infant Hospital of Rhode Island, Department of Obstetrics and Gynecology, Providence, Rhode Island 02905-2401, USA. mphipps@wihri.org
Sowers
Maryfran
M
DeMonner
Sonya M
SM
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000704:Analysis of Variance; D001719:Birth Certificates; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D003644:Death Certificates; D005220:Fathers / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology / Q000706:statistics & numerical data*; D012307:Risk Factors; D020954:Single-Parent Family; D014481:United States; D044465:White People / Q000706:statistics & numerical data