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Open Access Research article

Childbearing during adolescence and offspring mortality: findings from three population-based cohorts in southern Brazil

María C Restrepo-Méndez1*, Aluísio JD Barros1, Iná S Santos1, Ana MB Menezes1, Alicia Matijasevich1, Fernando C Barros2 and Cesar G Victora1

Author Affiliations

1 Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 3° Piso, 96020-220, Pelotas, Brazil

2 Postgraduate Course in Health and Behavior, Universidade Católica de Pelotas, Rua Félix da Cunha, 412 - 96010-000, Pelotas, Brazil

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BMC Public Health 2011, 11:781  doi:10.1186/1471-2458-11-781

Published: 10 October 2011

Abstract

Background

The role of young maternal age as a determinant of adverse child health outcomes is controversial, with existing studies providing conflicting results. This work assessed the association between adolescent childbearing and early offspring mortality in three birth cohort studies from the city of Pelotas in Southern Brazil.

Methods

All hospital births from 1982 (6,011), 1993 (5,304), and 2004 (4,287) were identified and these infants were followed up. Deaths were monitored through vital registration, visits to hospitals and cemeteries. The analyses were restricted to women younger than 30 years who delivered singletons (72%, 70% and 67% of the original cohorts, respectively). Maternal age was categorized into three groups (< 16, 16-19, and 20-29 years). Further analyses compared mothers aged 12-19 and 20-29 years. The outcome variables included fetal, perinatal, neonatal, postneonatal and infant mortality. Crude and adjusted odds ratios (ORs) were estimated with logistic regression models.

Results

There were no interactions between maternal age and cohort year. After adjustment for confounding, pooled ORs for mothers aged 12-19 years were 0.6 (95% CI = 0.4; 1.0) for fetal death, 0.9 (0.6; 1.3) for perinatal death, 1.0 (0.7; 1.6) for early neonatal death, 1.6 (0.7; 3.4) for late neonatal death, 1.8 (1.1; 2.9) for postneonatal death, and 1.6 (1.2; 2.1) for infant death, when compared to mothers aged 20-29 years. Further adjustment for mediating variables led to the disappearance of the excess of postneonatal mortality. The number of mothers younger than 16 years was not sufficient for most analyses.

Conclusion

The slightly increased odds of postneonatal mortality among children of adolescent mothers suggest that social and environmental factors may be more important than maternal biologic immaturity.

Keywords:
pregnancy in adolescence; infant mortality; neonatal mortality; perinatal mortality; fetal mortality; cohort studies