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Maternal age at childbirth and perinatal and under-five mortality in a prospective birth cohort from Delhi

Maternal age at childbirth and perinatal and under-five mortality in a prospective birth cohort from Delhi
Maternal age at childbirth and perinatal and under-five mortality in a prospective birth cohort from Delhi
OBJECTIVE: To evaluate the relationship between maternal age at child birth and perinatal and underfive mortality.

DESIGN: Prospective birth cohort.

SETTING: Urban community.

PARTICIPANTS: 9169 pregnancies in the New Delhi Birth Cohort resulted in 8181 live births. These children were followed for survival status and anthropometric measurements at birth (+3 days), 3, 6, 9 and 12 months (± 7 days), and every 6 months thereafter until 21 years age. Information on maternal age at child birth and socio-demographic profile was also obtained.

OUTCOME MEASURES: Offspring mortality from 28 weeks gestation till 5 years age.

RESULTS: Offspring mortality (stillbirths - 5 years; n=328) had a U-shaped association with maternal age (P< 0.001). Compared to the reference group (20-24 years), younger (? 19 years) and older (? 35 years) maternal ages were associated with a higher risk of offspring mortality (HR: 1.68; 95% CI 1.16, 2.43 and HR 1.48; 95% CI 1.01, 2.16, respectively). In young mothers, the increased risk persisted after adjustment for socio-economic confounders (maternal education, household income and wealth; HR 1.51; 95% CI 1.03, 2.20) and further for additional behavioural (place of delivery) and biological mediators (gestation and birth weight) (HR 2.14; 95% CI 1.25,3.64). Similar associations were documented for post-perinatal deaths but for perinatal mortality the higher risk was not statistically significant (P>0.05). In older mothers, the increased mortality risk was not statistically significant (P>0.05) after adjustment for socio-economic confounders.

CONCLUSION: Young motherhood is associated with an increased risk of post-perinatal mortality and measures to prevent early childbearing should be strengthened.
child mortality, perinatal mortality, maternal age, teenage pregnancy
0019-6061
871–877
Sinha, Sikha
19a9d7f0-2f65-4c91-a263-d41f8c2ec273
Aggarwal, Abba Rani
59b1f333-bee9-4f22-8c75-e97df6c0917c
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Fall, Caroline
7171a105-34f5-4131-89d7-1aa639893b18
Bhargava, Santosh K.
3932b4c9-c07d-472c-b54d-622306357475
Sachdev, Harshpal
25651485-1147-4080-ba2b-dde9614d0755
Sinha, Sikha
19a9d7f0-2f65-4c91-a263-d41f8c2ec273
Aggarwal, Abba Rani
59b1f333-bee9-4f22-8c75-e97df6c0917c
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Fall, Caroline
7171a105-34f5-4131-89d7-1aa639893b18
Bhargava, Santosh K.
3932b4c9-c07d-472c-b54d-622306357475
Sachdev, Harshpal
25651485-1147-4080-ba2b-dde9614d0755

Sinha, Sikha, Aggarwal, Abba Rani, Osmond, Clive, Fall, Caroline, Bhargava, Santosh K. and Sachdev, Harshpal (2016) Maternal age at childbirth and perinatal and under-five mortality in a prospective birth cohort from Delhi. Indian pediatrics, 53 (10), 871–877. (doi:10.1007/s13312-016-0950-9). (PMID:27484448)

Record type: Article

Abstract

OBJECTIVE: To evaluate the relationship between maternal age at child birth and perinatal and underfive mortality.

DESIGN: Prospective birth cohort.

SETTING: Urban community.

PARTICIPANTS: 9169 pregnancies in the New Delhi Birth Cohort resulted in 8181 live births. These children were followed for survival status and anthropometric measurements at birth (+3 days), 3, 6, 9 and 12 months (± 7 days), and every 6 months thereafter until 21 years age. Information on maternal age at child birth and socio-demographic profile was also obtained.

OUTCOME MEASURES: Offspring mortality from 28 weeks gestation till 5 years age.

RESULTS: Offspring mortality (stillbirths - 5 years; n=328) had a U-shaped association with maternal age (P< 0.001). Compared to the reference group (20-24 years), younger (? 19 years) and older (? 35 years) maternal ages were associated with a higher risk of offspring mortality (HR: 1.68; 95% CI 1.16, 2.43 and HR 1.48; 95% CI 1.01, 2.16, respectively). In young mothers, the increased risk persisted after adjustment for socio-economic confounders (maternal education, household income and wealth; HR 1.51; 95% CI 1.03, 2.20) and further for additional behavioural (place of delivery) and biological mediators (gestation and birth weight) (HR 2.14; 95% CI 1.25,3.64). Similar associations were documented for post-perinatal deaths but for perinatal mortality the higher risk was not statistically significant (P>0.05). In older mothers, the increased mortality risk was not statistically significant (P>0.05) after adjustment for socio-economic confounders.

CONCLUSION: Young motherhood is associated with an increased risk of post-perinatal mortality and measures to prevent early childbearing should be strengthened.

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Association between maternal age at childbirth and perinatal and under-five mortality in a prospective birth cohort from Delhi.doc - Accepted Manuscript
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Accepted/In Press date: 1 July 2016
e-pub ahead of print date: 19 October 2016
Published date: October 2016
Keywords: child mortality, perinatal mortality, maternal age, teenage pregnancy
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 399237
URI: http://eprints.soton.ac.uk/id/eprint/399237
ISSN: 0019-6061
PURE UUID: 00c9b530-c959-4020-b388-6569e0821cc5
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655
ORCID for Caroline Fall: ORCID iD orcid.org/0000-0003-4402-5552

Catalogue record

Date deposited: 09 Aug 2016 11:00
Last modified: 18 Feb 2021 16:45

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Contributors

Author: Sikha Sinha
Author: Abba Rani Aggarwal
Author: Clive Osmond ORCID iD
Author: Caroline Fall ORCID iD
Author: Santosh K. Bhargava
Author: Harshpal Sachdev

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