Sikha Sinha1, Abha Rani Aggarwal, Clive Osmond, Caroline Hd Fall, Santosh K Bhargava, Harshpal Singh Sachdev. 1. Sitaram Bhartia Institute of Science and Research, New Delhi, India; #University School of Medicine and Para-medical Health Sciences, Guru Gobind Singh Indraprastha University, Delhi, India; National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India; ‡MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; and ^Sunder Lal Jain Hospital, New Delhi, India. Correspondence to: Prof HPS Sachdev, Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, B-16 Qutab Institutional Area, New Delhi 110 016, India. hpssachdev@gmail.com.
Abstract
OBJECTIVE: To evaluate the relationship between maternal age at child birth, and perinatal and under-five mortality. DESIGN: Prospective birth cohort. SETTING: Urban community. PARTICIPANTS: 9169 pregnancies in the New Delhi Birth Cohort resulted in 8181 live births. These children were followed for survival status and anthropometric measurements at birth (+3 days), 3,6,9 and 12 months (7 days), and every 6 months thereafter until 21 years age. Information on maternal age at child birth and socio-demographic profile was also obtained. OUTCOME MEASURES: Offspring mortality from 28 weeks gestation till 5 years age. RESULTS: Offspring mortality (stillbirths - 5 years; n=328) had a U-shaped association with maternal age (P<0.001). Compared to the reference group (20-24 years), younger (≤19 years) and older (≥35 years) maternal ages were associated with a higher risk of offspring mortality (HR: 1.68; 95% CI 1.16, 2.43 and HR 1.48; 95% CI 1.01, 2.16, respectively). In young mothers, the increased risk persisted after adjustment for socio-economic confounders (maternal education, household income and wealth; HR 1.51; 95% CI 1.03, 2.20) and further for additional behavioral (place of delivery) and biological mediators (gestation and birthweight) (HR 2.14; 95% CI 1.25,3.64). Similar associations were documented for post-perinatal deaths but for perinatal mortality the higher risk was not statistically significant (P >0.05). In older mothers, the increased mortality risk was not statistically significant (P >0.05) after adjustment for socio-economic confounders. CONCLUSION: Young motherhood is associated with an increased risk of post-perinatal mortality and measures to prevent early childbearing should be strengthened.
OBJECTIVE: To evaluate the relationship between maternal age at child birth, and perinatal and under-five mortality. DESIGN: Prospective birth cohort. SETTING: Urban community. PARTICIPANTS: 9169 pregnancies in the New Delhi Birth Cohort resulted in 8181 live births. These children were followed for survival status and anthropometric measurements at birth (+3 days), 3,6,9 and 12 months (7 days), and every 6 months thereafter until 21 years age. Information on maternal age at child birth and socio-demographic profile was also obtained. OUTCOME MEASURES: Offspring mortality from 28 weeks gestation till 5 years age. RESULTS: Offspring mortality (stillbirths - 5 years; n=328) had a U-shaped association with maternal age (P<0.001). Compared to the reference group (20-24 years), younger (≤19 years) and older (≥35 years) maternal ages were associated with a higher risk of offspring mortality (HR: 1.68; 95% CI 1.16, 2.43 and HR 1.48; 95% CI 1.01, 2.16, respectively). In young mothers, the increased risk persisted after adjustment for socio-economic confounders (maternal education, household income and wealth; HR 1.51; 95% CI 1.03, 2.20) and further for additional behavioral (place of delivery) and biological mediators (gestation and birthweight) (HR 2.14; 95% CI 1.25,3.64). Similar associations were documented for post-perinatal deaths but for perinatal mortality the higher risk was not statistically significant (P >0.05). In older mothers, the increased mortality risk was not statistically significant (P >0.05) after adjustment for socio-economic confounders. CONCLUSION: Young motherhood is associated with an increased risk of post-perinatal mortality and measures to prevent early childbearing should be strengthened.
Authors: R K Kapoor; A K Srivastava; P K Misra; B Sharma; S Thakur; K I Srivastava; G K Singh Journal: Indian Pediatr Date: 1996-01 Impact factor: 1.411
Authors: María C Restrepo-Méndez; Aluísio J D Barros; Iná S Santos; Ana M B Menezes; Alicia Matijasevich; Fernando C Barros; Cesar G Victora Journal: BMC Public Health Date: 2011-10-10 Impact factor: 3.295
Authors: Caroline H D Fall; Harshpal Singh Sachdev; Clive Osmond; Maria Clara Restrepo-Mendez; Cesar Victora; Reynaldo Martorell; Aryeh D Stein; Shikha Sinha; Nikhil Tandon; Linda Adair; Isabelita Bas; Shane Norris; Linda M Richter Journal: Lancet Glob Health Date: 2015-05-18 Impact factor: 26.763
Authors: Santosh K Bhargava; Harshpal Singh Sachdev; Caroline H D Fall; Clive Osmond; Ramakrishnan Lakshmy; David J P Barker; Sushant K Dey Biswas; Siddharth Ramji; Dorairaj Prabhakaran; Kolli Srinath Reddy Journal: N Engl J Med Date: 2004-02-26 Impact factor: 91.245