TY  - JOUR
T1  - YOung maternal age and the risk of neonatal mortality in rural nepal
AU  - Sharma V, Katz J, Mullany LC, et al
Y1  - 2008/09/01
N1  - 10.1001/archpedi.162.9.828
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 828
EP  - 835
VL  - 162
IS  - 9
N2  - Objectives 
    To investigate the relationship between adolescent pregnancy and neonatal mortality in a nutritionally deprived population in rural Nepal, and to determine mechanisms through which low maternal age may affect neonatal mortality.Design 
    Nested cohort study using data from a population-based, cluster-randomized, placebo-controlled trial of newborn skin and umbilical cord cleansing with chlorhexidine.Setting 
    Sarlahi District of Nepal.Participants 
    Live-born singleton infants of mothers younger than 25 years who were either parity 0 or 1 (n = 10 745).Main Exposure 
    Maternal age at birth of offspring.Outcome Measure 
    Crude and adjusted odds ratios of neonatal mortality by maternal age category.Results 
    Infants born to mothers aged 12 to 15 years were at a higher risk of neonatal mortality than those born to women aged 20 to 24 years (odds ratio, 2.24; 95% confidence interval, 1.40-3.59). After adjustment for confounders, there was a 53% excess risk of neonatal mortality among infants born to mothers in the youngest vs oldest age category (1.53; 0.90-2.60). This association was attenuated on further adjustment for low birth weight, preterm birth, or small-for-gestational-age births.Conclusions 
    The higher risk of neonatal mortality among younger mothers in this setting is partially explained by differences in socioeconomic factors in younger vs older mothers; risk is mediated primarily through preterm delivery, low birth weight, newborns being small for gestational age, and/or some interaction of these variables.Trial Registration 
    clinicaltrials.gov Identifier: NCT00109616
SN  - 1072-4710
M3  - doi: 10.1001/archpedi.162.9.828
UR  - http://dx.doi.org/10.1001/archpedi.162.9.828
ER  -