The Risk for Infant Mortality among Adolescent Childbearing Groups

Abstract

Objective: To evaluate risk disparities and risk factors for infant mortality among adolescent childbearing age groups. Methods: We combined the 1995 and 1996 comprehensive U.S. birth cohorts provided by the National Center for Heath Statistics. Our analysis included 777,762 singleton, first births to women aged 12-19 years linked to 4631 infant deaths. We used both bivariate comparisons and multivariable logistic regression for our analysis, with infant mortality as our main outcome measure. Results: Rates of infant mortality are substantially higher for ≤15-year-olds (8.1/1000 live births) compared with 16-17-year-olds (6.3/1000 live births) and 18-19-year-olds (5.4/1000 live births). Even after adjusting for risk factors associated with poor outcomes, including alcohol use, tobacco use, and prenatal care use, the risk for infant mortality was 1.6 (95% confidence interval [95% CI] 1.4, 1.7) times greater for infants of mothers ≤15 years old as compared with those mothers 18-19 years old. In the ≤15-year-old group, 62% of fathers were not reported on the child's birth certificate. Not reporting the father was associated with a 24% increased risk for infant mortality after adjusting for maternal and infant risk factors. Conclusions: Childbearing in ≤15-year-olds is associated with a substantial increased risk for infant mortality compared with childbearing in older adolescence. This study suggests that not reporting the father on a birth certificate is a potential risk marker. Risk differences among adolescent age groups may be important to consider when creating tailored intervention and prevention strategies.