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Maternal age at childbirth and perinatal and under-five mortality in a prospective birth cohort from Delhi

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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.

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Author information

Authors and Affiliations

  1. Sitaram Bhartia Institute of Science and Research, New Delhi, India

    Sikha Sinha & Harshpal Singh Sachdev

  2. University School of Medicine and Para-medical Health Sciences, Guru Gobind Singh Indraprastha University, Delhi, India

    Sikha Sinha

  3. National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India

    Abha Rani Aggarwal

  4. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    Clive Osmond & Caroline H. D. Fall

  5. Sunder Lal Jain Hospital, New Delhi, India

    Santosh K. Bhargava

  6. Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, B-16 Qutab Institutional Area, New Delhi, 110 016, India

    Harshpal Singh Sachdev

Authors
  1. Sikha Sinha
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  2. Abha Rani Aggarwal
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  3. Clive Osmond
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  4. Caroline H. D. Fall
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  5. Santosh K. Bhargava
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  6. Harshpal Singh Sachdev
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Correspondence to Harshpal Singh Sachdev.

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Sinha, S., Aggarwal, A.R., Osmond, C. et al. Maternal age at childbirth and perinatal and under-five mortality in a prospective birth cohort from Delhi. Indian Pediatr 53, 871–877 (2016). https://doi.org/10.1007/s13312-016-0950-9

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  • DOI: https://doi.org/10.1007/s13312-016-0950-9

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