Document Detail

Young maternal age and the risk of neonatal mortality in rural Nepal.
MedLine Citation:
PMID:  18762599     Owner:  NLM     Status:  MEDLINE    
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: Identifier: NCT00109616.
Vandana Sharma; Joanne Katz; Luke C Mullany; Subarna K Khatry; Steven C LeClerq; Sharada R Shrestha; Gary L Darmstadt; James M Tielsch
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  162     ISSN:  1538-3628     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-02     Completed Date:  2008-09-23     Revised Date:  2014-09-21    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  828-35     Citation Subset:  AIM; IM    
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MeSH Terms
Anti-Infective Agents, Local / therapeutic use
Chlorhexidine / therapeutic use
Infant Mortality*
Infant, Newborn
Logistic Models
Maternal Age*
Nepal / epidemiology
Postnatal Care
Pregnancy in Adolescence
Randomized Controlled Trials as Topic
Risk Factors
Grant Support
HD 38753/HD/NICHD NIH HHS; HD 44004/HD/NICHD NIH HHS; R01 HD038753/HD/NICHD NIH HHS; R01 HD038753-01/HD/NICHD NIH HHS; R01 HD038753-02/HD/NICHD NIH HHS; R01 HD038753-03/HD/NICHD NIH HHS; R01 HD038753-03S1/HD/NICHD NIH HHS; R01 HD038753-04/HD/NICHD NIH HHS; R01 HD044004/HD/NICHD NIH HHS; R01 HD044004-01/HD/NICHD NIH HHS; R01 HD044004-02/HD/NICHD NIH HHS; R01 HD044004-03/HD/NICHD NIH HHS; R03 HD049406/HD/NICHD NIH HHS; R03 HD049406-01/HD/NICHD NIH HHS; R03 HD049406-02/HD/NICHD NIH HHS; R03HD49406/HD/NICHD NIH HHS
Reg. No./Substance:
0/Anti-Infective Agents, Local; R4KO0DY52L/Chlorhexidine

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