TY - JOUR
T1 - Characteristics and birth outcomes of pregnant adolescents compared to older women
T2 - An analysis of individual level data from 140,000 mothers from 20 RCTs
AU - The Global Young Women's Nutrition Investigators Group
AU - Akseer, Nadia
AU - Keats, Emily Catherine
AU - Thurairajah, Pravheen
AU - Cousens, Simon
AU - Bétran, Ana Pilar
AU - Oaks, Brietta M.
AU - Osrin, David
AU - Piwoz, Ellen
AU - Gomo, Exnevia
AU - Ahmed, Faruk
AU - Friis, Henrik
AU - Belizán, José
AU - Dewey, Kathryn
AU - West, Keith
AU - Huybregts, Lieven
AU - Zeng, Lingxia
AU - Dibley, Michael J.
AU - Zagre, Noel
AU - Christian, Parul
AU - Kolsteren, Patrick Wilfried
AU - Kaestel, Pernille
AU - Black, Robert E.
AU - El Arifeen, Shams
AU - Ashorn, Ulla
AU - Fawzi, Wafaie
AU - Bhutta, Zulfiqar Ahmed
N1 - Funding Information:
ZAB conceptualised the study and wrote the proposal for funding with NA. ECK managed all coordination activities of the study, including with the wider Consortium members. PT performed the systematic review and managed, cleaned, and merged the received individual participant data, with oversight from NA and ECK. SC cleaned/managed all the individual-level data and provided substantial oversight on all analyses, which were conducted by NA and ECK. Authors named as members of the Global Young Women's Nutrition Investigators Group made substantial intellectual contributions throughout the study as Technical Advisors or Steering Committee members, and/or provided individual-level data. NA and ECK drafted and revised the manuscript with input from all co-authors. All authors can take responsibility for the integrity of the data and accuracy of the data analysis. NA, ECK, and SC had access to the study dataset and ZAB decided to submit the study for publication.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/3
Y1 - 2022/3
N2 - Background: Adolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10–19 years) compared to older mothers in low and middle-income countries. Methods: This study was conducted between March 16, 2018 and May 25, 2021. Data were obtained from 20 randomised controlled trials of micronutrient supplementation in pregnancy. Stratified analyses were conducted by age (10–14 years, 15–17 years, 18–19 years, 20–29 years, 30–39 years, 40+ years) and geographical region (Africa, Asia). Crude and confounder-adjusted means, prevalence and relative risks of pregnancy, nutrition and birth outcomes were estimated using multivariable linear and log-binomial regression models with 95% confidence intervals. Findings: Adolescent mothers comprised 31.6% of our data. Preterm birth, small-for-gestational age (SGA), low birthweight (LBW) and newborn mortality followed a U-shaped trend in which prevalence was highest among the youngest mothers (10–14 years) and then reduced gradually, but increased again for older mothers (40+ years). When compared to mothers aged 20–29 years, there was a 23% increased risk of preterm birth, a 60% increased risk of perinatal mortality, a 63% increased risk of neonatal mortality, a 28% increased risk of LBW, and a 22% increased risk of SGA among mothers 10–14 years. Mothers 40+ years experienced a 22% increased risk of preterm birth and a 103% increased risk of stillbirth when compared to the 20–29 year group. Interpretation: The youngest and oldest mothers suffer most from adverse pregnancy and birth outcomes. Policy and programming agendas should consider both biological and socioeconomic/environmental factors when targeting these populations. Funding: Bill and Melinda Gates Foundation (Grant No: OP1137750).
AB - Background: Adolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10–19 years) compared to older mothers in low and middle-income countries. Methods: This study was conducted between March 16, 2018 and May 25, 2021. Data were obtained from 20 randomised controlled trials of micronutrient supplementation in pregnancy. Stratified analyses were conducted by age (10–14 years, 15–17 years, 18–19 years, 20–29 years, 30–39 years, 40+ years) and geographical region (Africa, Asia). Crude and confounder-adjusted means, prevalence and relative risks of pregnancy, nutrition and birth outcomes were estimated using multivariable linear and log-binomial regression models with 95% confidence intervals. Findings: Adolescent mothers comprised 31.6% of our data. Preterm birth, small-for-gestational age (SGA), low birthweight (LBW) and newborn mortality followed a U-shaped trend in which prevalence was highest among the youngest mothers (10–14 years) and then reduced gradually, but increased again for older mothers (40+ years). When compared to mothers aged 20–29 years, there was a 23% increased risk of preterm birth, a 60% increased risk of perinatal mortality, a 63% increased risk of neonatal mortality, a 28% increased risk of LBW, and a 22% increased risk of SGA among mothers 10–14 years. Mothers 40+ years experienced a 22% increased risk of preterm birth and a 103% increased risk of stillbirth when compared to the 20–29 year group. Interpretation: The youngest and oldest mothers suffer most from adverse pregnancy and birth outcomes. Policy and programming agendas should consider both biological and socioeconomic/environmental factors when targeting these populations. Funding: Bill and Melinda Gates Foundation (Grant No: OP1137750).
KW - Adolescence
KW - Age
KW - Birth outcomes
KW - Determinants
KW - Pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85126090107&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85126090107&partnerID=8YFLogxK
U2 - 10.1016/j.eclinm.2022.101309
DO - 10.1016/j.eclinm.2022.101309
M3 - Article
C2 - 35243274
AN - SCOPUS:85126090107
SN - 2589-5370
VL - 45
JO - EClinicalMedicine
JF - EClinicalMedicine
M1 - 101309
ER -