Characteristics and birth outcomes of pregnant adolescents compared to older women: An analysis of individual level data from 140,000 mothers from 20 RCTs
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Characteristics and birth outcomes of pregnant adolescents compared to older women: An analysis of individual level data from 140,000 mothers from 20 RCTs. / Akseer, Nadia; Keats, Emily Catherine; Thurairajah, Pravheen; Cousens, Simon; Bétran, Ana Pilar; Friis, Henrik; Kæstel, Pernille; Ashorn, Ulla; Fawzi, Wafaie; Bhutta, Zulfiqar Ahmed; Global Young Women's Nutrition Investigators Group.
I: EClinicalMedicine, Bind 45, 101309, 2022.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Characteristics and birth outcomes of pregnant adolescents compared to older women: An analysis of individual level data from 140,000 mothers from 20 RCTs
AU - Akseer, Nadia
AU - Keats, Emily Catherine
AU - Thurairajah, Pravheen
AU - Cousens, Simon
AU - Bétran, Ana Pilar
AU - Oaks, Brietta M
AU - Osrin, David
AU - Piwoz, Ellen
AU - Gomo, Exnevia
AU - Ahmed, Faruk
AU - Friis, Henrik
AU - Belizán, José
AU - Dewey, Kathryn
AU - West, Keith
AU - Huybregts, Lieven
AU - Zeng, Lingxia
AU - Dibley, Michael J
AU - Zagre, Noel
AU - Christian, Parul
AU - Kolsteren, Patrick Wilfried
AU - Kæstel, Pernille
AU - Black, Robert E
AU - El Arifeen, Shams
AU - Ashorn, Ulla
AU - Fawzi, Wafaie
AU - Bhutta, Zulfiqar Ahmed
AU - Global Young Women's Nutrition Investigators Group
N1 - © 2022 The Author(s). Funding: Bill and Melinda Gates Foundation (Grant No: OP1137750).
PY - 2022
Y1 - 2022
N2 - Background: Adolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10-19 years) compared to older mothers in low and middle-income countries.Methods: This study was conducted between March 16, 2018 and May 25, 2021. Data were obtained from 20 randomised controlled trials of micronutrient supplementation in pregnancy. Stratified analyses were conducted by age (10-14 years, 15-17 years, 18-19 years, 20-29 years, 30-39 years, 40+ years) and geographical region (Africa, Asia). Crude and confounder-adjusted means, prevalence and relative risks of pregnancy, nutrition and birth outcomes were estimated using multivariable linear and log-binomial regression models with 95% confidence intervals.Findings: Adolescent mothers comprised 31.6% of our data. Preterm birth, small-for-gestational age (SGA), low birthweight (LBW) and newborn mortality followed a U-shaped trend in which prevalence was highest among the youngest mothers (10-14 years) and then reduced gradually, but increased again for older mothers (40+ years). When compared to mothers aged 20-29 years, there was a 23% increased risk of preterm birth, a 60% increased risk of perinatal mortality, a 63% increased risk of neonatal mortality, a 28% increased risk of LBW, and a 22% increased risk of SGA among mothers 10-14 years. Mothers 40+ years experienced a 22% increased risk of preterm birth and a 103% increased risk of stillbirth when compared to the 20-29 year group.Interpretation: The youngest and oldest mothers suffer most from adverse pregnancy and birth outcomes. Policy and programming agendas should consider both biological and socioeconomic/environmental factors when targeting these populations.
AB - Background: Adolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10-19 years) compared to older mothers in low and middle-income countries.Methods: This study was conducted between March 16, 2018 and May 25, 2021. Data were obtained from 20 randomised controlled trials of micronutrient supplementation in pregnancy. Stratified analyses were conducted by age (10-14 years, 15-17 years, 18-19 years, 20-29 years, 30-39 years, 40+ years) and geographical region (Africa, Asia). Crude and confounder-adjusted means, prevalence and relative risks of pregnancy, nutrition and birth outcomes were estimated using multivariable linear and log-binomial regression models with 95% confidence intervals.Findings: Adolescent mothers comprised 31.6% of our data. Preterm birth, small-for-gestational age (SGA), low birthweight (LBW) and newborn mortality followed a U-shaped trend in which prevalence was highest among the youngest mothers (10-14 years) and then reduced gradually, but increased again for older mothers (40+ years). When compared to mothers aged 20-29 years, there was a 23% increased risk of preterm birth, a 60% increased risk of perinatal mortality, a 63% increased risk of neonatal mortality, a 28% increased risk of LBW, and a 22% increased risk of SGA among mothers 10-14 years. Mothers 40+ years experienced a 22% increased risk of preterm birth and a 103% increased risk of stillbirth when compared to the 20-29 year group.Interpretation: The youngest and oldest mothers suffer most from adverse pregnancy and birth outcomes. Policy and programming agendas should consider both biological and socioeconomic/environmental factors when targeting these populations.
KW - Faculty of Science
KW - Adolescence
KW - Age
KW - Determinants
KW - Pregnancy
KW - Birth outcomes
U2 - 10.1016/j.eclinm.2022.101309
DO - 10.1016/j.eclinm.2022.101309
M3 - Journal article
C2 - 35243274
VL - 45
JO - EClinicalMedicine
JF - EClinicalMedicine
SN - 2589-5370
M1 - 101309
ER -
ID: 299398159