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The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis.

Abstract：

BACKGROUND:Previous studies have reported on adverse neonatal outcomes associated with parity and maternal age. Many of these studies have relied on cross-sectional data, from which drawing causal inference is complex. We explore the associations between parity/maternal age and adverse neonatal outcomes using data from cohort studies conducted in low- and middle-income countries (LMIC). METHODS:Data from 14 cohort studies were included. Parity (nulliparous, parity 1-2, parity ≥ 3) and maternal age (<18 years, 18-<35 years, ≥ 35 years) categories were matched with each other to create exposure categories, with those who are parity 1-2 and age 18-<35 years as the reference. Outcomes included small-for-gestational-age (SGA), preterm, neonatal and infant mortality. Adjusted odds ratios (aOR) were calculated per study and meta-analyzed. RESULTS:Nulliparous, age <18 year women, compared with women who were parity 1-2 and age 18-<35 years had the highest odds of SGA (pooled adjusted OR: 1.80), preterm (pooled aOR: 1.52), neonatal mortality (pooled aOR: 2.07), and infant mortality (pooled aOR: 1.49). Increased odds were also noted for SGA and neonatal mortality for nulliparous/age 18-<35 years, preterm, neonatal, and infant mortality for parity ≥ 3/age 18-<35 years, and preterm and neonatal mortality for parity ≥ 3/≥ 35 years. CONCLUSIONS:Nulliparous women <18 years of age have the highest odds of adverse neonatal outcomes. Family planning has traditionally been the least successful in addressing young age as a risk factor; a renewed focus must be placed on finding effective interventions that delay age at first birth. Higher odds of adverse outcomes are also seen among parity ≥ 3 / age ≥ 35 mothers, suggesting that reproductive health interventions need to address the entirety of a woman's reproductive period. FUNDING:Funding was provided by the Bill & Melinda Gates Foundation (810-2054) by a grant to the US Fund for UNICEF to support the activities of the Child Health Epidemiology Reference Group.

journal_name

BMC Public Health

journal_title

BMC public health

authors

Kozuki N,Lee AC,Silveira MF,Sania A,Vogel JP,Adair L,Barros F,Caulfield LE,Christian P,Fawzi W,Humphrey J,Huybregts L,Mongkolchati A,Ntozini R,Osrin D,Roberfroid D,Tielsch J,Vaidya A,Black RE,Katz J,Child Health E

doi

10.1186/1471-2458-13-S3-S2

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

issn

1471-2458

pii

1471-2458-13-S3-S2

journal_volume

13 Suppl 3

pub_type

杂志文章,meta分析

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The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis.