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Original Article| Volume 61, ISSUE 7, P688-694, July 2008

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Increased risks of neonatal and postneonatal mortality associated with teenage pregnancy had different explanations

  • Xi-Kuan Chen
    Affiliations
    OMNI Research Group, Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6

    Clinical Epidemiology Program, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6
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  • Shi Wu Wen
    Correspondence
    Corresponding author. OMNI Research Group, Department of Obstetrics & Gynecology, University of Ottawa, 501 Smyth Road, Box 241, Ottawa, Ontario, Canada K1H 8L6.
    Affiliations
    OMNI Research Group, Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6

    Clinical Epidemiology Program, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6

    Department of Epidemiology and Community Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada K1H 8L6
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  • Nathalie Fleming
    Affiliations
    Pediatric Adolescent Gynecology, Children's Hospital of East Ontario, University of Ottawa, Ontario, Canada K1H 8L1
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  • Qiuying Yang
    Affiliations
    OMNI Research Group, Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6

    Clinical Epidemiology Program, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6
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  • Mark C. Walker
    Affiliations
    OMNI Research Group, Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6

    Clinical Epidemiology Program, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6

    Department of Epidemiology and Community Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada K1H 8L6
    Search for articles by this author

      Abstract

      Objective

      To determine the potential pathway of the association between teenage pregnancy and neonatal and postneonatal mortality.

      Study Design and setting

      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).

      Conclusion

      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.

      Keywords

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