effects of race, residence, and prenatal care on the relationship of maternal age to neonatal mortality

• Published in: American journal of public health (1971) 1986-12, Vol.76 (12), p.1416-1421
• Main Author: Geronimus, A.T
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; African Americans; age; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Birth Weight; Clinical death. Palliative care. Organ gift and preservation; Data Collection; European Continental Ancestry Group; Female; Humans; Infant Mortality; Maternal Age; Medical sciences; nationalities and ethnic groups; patient care; Pregnancy; Pregnancy in Adolescence; Prenatal Care; prenatal period; United States
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.76.12.1416

Extract: This population-based study explores whether excessive neonatal mortality rates (NMRs) among infants with teenage mothers are attributable to young maternal age or to a translation of environmental disadvantage into reproductive disadvantage. First births from the 1976-79 linked birth and infant death registers for three states are analyzed. The data set is sufficiently large (305,907 births) to measure maternal age in fine gradations while including several control variables in logit analyses. The associations of racial identification and prenatal care with low birthweight, short gestation, and neonatal mortality overshadow and confound the association between teenage and poor outcome. At every maternal age, higher NMRs are observed for Blacks compared to Whites. The hypothesis that excessive neonatal mortality among Blacks is due to the greater frequency of teenage childbearing among Blacks is refuted. Indeed, unlike White, Black primiparae above age 23 experience higher NMRs than most Black or White teenagers. These results suggest that teenage maternity is not the primary causal agent of all of the problems with which it is associated.(author)