Increased risks of neonatal and postneonatal mortality associated with teenage pregnancy had different explanations.
OBJECTIVE
To determine the potential pathway of the association between teenage pregnancy and neonatal and postneonatal mortality.


METHODS
We carried out a retrospective cohort study of 4,037,009 nulliparous pregnant women under 25 years old who had a live singleton birth during 1995 to 2000, based on linked birth and infant death data set of the United States.


RESULTS
Teenage pregnancy (10-19 years old) was associated with increased neonatal mortality (odds ratio [OR]: 1.20, 95% confidence interval [CI]=1.16-1.24) and postneonatal mortality (OR: 1.47, 95% CI=1.41-1.54) after adjustment for potential confounders. With further adjustment for weight gain during pregnancy, teenage pregnancy was still associated with increased risk of neonatal (OR: 1.23, 95% CI=1.19-1.28) and postneonatal mortality (OR: 1.48, 95% CI=1.42-1.55). When adjustment was made for gestational age at birth, there was no association of teenage pregnancy with neonatal mortality (OR: 0.98, 95% CI=0.95-1.02), whereas there was significant association with postneonatal mortality (OR: 1.40, 95% CI=1.34-1.46).


CONCLUSIONS
The increased risk of neonatal death associated with teenage pregnancy is largely attributable to higher risk of preterm births, whereas increased postneonatal mortality is independent of the known confounders and gestational age at birth.
Chen
Xi-Kuan
XK
OMNI Research Group, Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6.
Wen
Shi Wu
SW
Fleming
Nathalie
N
Yang
Qiuying
Q
Walker
Mark C
MC
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000208:ethnology; D007231:Infant, Newborn; D007234:Infant, Premature; D008423:Maternal Age; D016017:Odds Ratio; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology; D012189:Retrospective Studies; D012306:Risk; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology