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Defining early adolescent childbearing
Maureen G Phipps1, MaryFran Sowers
1Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
Insights
Early adolescent childbearing is best defined as giving birth at 15 years or younger. This definition is based on analyzing adverse clinical outcomes like infant mortality and preterm birth rates in a large US birth cohort.
Area of Science:
- Reproductive Health
- Perinatal Epidemiology
- Adolescent Health
Background:
- Adolescent childbearing is associated with increased risks for adverse birth outcomes.
- Establishing a precise age-based definition for early adolescent childbearing is crucial for targeted interventions and public health strategies.
Purpose of the Study:
- To determine the optimal age group for defining early adolescent childbearing.
- To base this definition on statistically significant inflection points in adverse clinical outcomes.
Main Methods:
- Analysis of a large US birth cohort (n=768,029) from 1995.
- Examination of singleton first births to mothers aged 12-23 years.
- Assessment of infant mortality, very low birthweight, and very preterm delivery rates per 1000 live births.
Main Results:
- Adverse clinical outcome rates (infant mortality, very low birthweight, very preterm delivery) were graphed by maternal age.
- An inflection point, below which adverse outcome rates stabilize, was identified at 16 years of maternal age.
- These inflection points remained consistent across major US racial/ethnic groups.
Conclusions:
- Early adolescent childbearing is statistically best defined as occurring at 15 years of maternal age or younger.
- This definition is supported by population-based data on birth outcomes.
- The findings provide a clear, evidence-based case definition for public health and research purposes.
Objectives:
This study determined the age group for the case definition of early adolescent childbearing based on rates of adverse clinical outcomes.
Methods:
We examined rates of infant mortality, very low birthweight (<1500 g), and very preterm delivery (<32 weeks) per 1000 live births for all US singleton first births (n = 768 029) to women aged 12 to 23 years in the 1995 US birth cohort.
Results:
Rates of infant mortality, very low birthweight, and very preterm delivery were graphed by maternal age. In all 3 cases, the inflection point below which the rate of poor birth outcome is lower and begins to stabilize is at 16 years; therefore, mothers 15 years and younger were grouped together to determine the case definition of early adolescent childbearing. The inflection points were similar when outcomes were stratified by the 3 largest US racial/ethnic groups (non-Hispanic White, non-Hispanic Black, and Mexican American).
Conclusions:
From this population-based analysis of birth outcomes, we conclude that early adolescent childbearing is best defined as giving birth at 15 years or younger.