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ORIGINAL ARTICLE
Year : 2018  |  Volume : 9  |  Issue : 2  |  Page : 78-80

Study of the early perinatal outcomes in babies born to young and older mothers


Department of Pediatrics, FMMCH, Mangalore, Karnataka, India

Date of Web Publication27-Nov-2018

Correspondence Address:
Dr. Swathi Shenoy
D/o Subraya Shenoy, ‘ShriSha’, Darbe, Puttur - 574 202, Karnataka
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjmsr.mjmsr_64_17

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  Abstract 


Background: Pregnancy at young age has been recognized as one of the most important social and public health issues all over the world. Studies done have shown that these are the adverse outcomes and complications linked to pregnancy at a young age such as the need for instrumental delivery or cesarean section, postpartum hemorrhage, prematurity, low birth weight, low APGAR score, Neonatal Intensive Care Unit (NICU) admissions, and perinatal mortality are significant. The aim of our study was to know the neonatal outcomes (birth weight, APGAR score, and NICU admissions) in young mothers and older mothers and to compare the neonatal outcomes of these two groups. Materials and Methods: Our study was a retrospective chart-based study, done in neonates delivered to young mothers (19–21 years) and older mothers (22–30 years). Parameters included in our study were period of gestation, birth weight, APGAR at 1 min and 5 min, NICU admissions, and neonatal outcomes such as asphyxia, hypoglycemia, jaundice, convulsion, and sepsis. Data were recorded in a pro forma. Collected data were analyzed using frequency, percentage, Chi-square test, and odds ratio. Results: A total of 330 neonates were included in the study (165 cases and 165 controls). In young mothers, there was higher incidence of preterm deliveries, 60 cases as compared to 9 controls were of gestational age 28–34 weeks, 60 cases had low birth weight as compared to 21 babies in the control group, and 90 babies born to young mother's required NICU admissions as compared to 23 babies born to older mothers. Neonates born to younger mothers had a higher incidence of NICU admissions, hypoglycemia, sepsis, and neonatal hyperbilirubinemia as compared to older mothers, whereas the incidence of APGAR at 1 min and 5 min showed no correlation between both the groups. Conclusion: Young mothers had a higher incidence of having preterm babies, low birth weight babies, with comorbidities and NICU admissions as compared to older mothers.

Keywords: APGAR score, low birth weight, perinatal outcome, young maternal age


How to cite this article:
Shenoy S, Hegde P, Khan HU, Jaidev M D. Study of the early perinatal outcomes in babies born to young and older mothers. Muller J Med Sci Res 2018;9:78-80

How to cite this URL:
Shenoy S, Hegde P, Khan HU, Jaidev M D. Study of the early perinatal outcomes in babies born to young and older mothers. Muller J Med Sci Res [serial online] 2018 [cited 2018 Dec 14];9:78-80. Available from: http://www.mjmsr.net/text.asp?2018/9/2/78/246176




  Introduction Top


Pregnancy at a young age is a significant public health issue, as it has been associated with increased risk of obstetric complications and adverse neonatal outcomes. It has been recognized as one of the most important social and public health issues worldwide.[1] The adverse outcomes are due to physiological and anatomical factors associated with young maternal age, while studies done have shown that they are due to external factors such as socioeconomic status, insufficient antenatal care, and other behavioral determinants associated with adolescence.[2],[3],[4],[5] Although the legal age for marriage in India is 18 years, data of National Family Health Survey-4 revealed that 21.4% of women were married before 18 years of age, of which 7.9% had already started childbearing which had led to adverse obstetric and neonatal outcomes.[6] Malnourishment was found to be an important confounding factor in a substantial proportion of young married girls (47%).[6] Studies done have shown that the adverse outcomes and complications linked to pregnancy at a young age such as the need for instrumental delivery or cesarean section, postpartum hemorrhage, prematurity, low birth weight, low APGAR score, Neonatal Intensive Care Unit (NICU) admissions, and perinatal mortality are significant.[7],[8]


  Materials and Methods Top


A retrospective chart-based study of previous 2 years was done in a tertiary care hospital from September 2017. All babies born to young mothers (19–21 years) were taken as cases and babies born to mothers aged 22–30 years were taken as controls. Neonates born to mothers with chronic illnesses of lungs, kidney, and heart and with obstetric complications were excluded from the study. Controls were selected in the ratio 1:1 and the controls were the babies born to women between 22 and 30 years who delivered next as that of the cases delivered and by the same mode of delivery. Data were collected based on the inclusion and exclusion criteria which was done by going through the medical records of the mother/neonate admitted in our hospital.

Following parameters such as gestational age, birth weight, small for gestational age, neonatal outcomes, APGAR score at 1 min and 5 min, ICU admissions, hypoglycemia, asphyxia, neonatal hyperbilirubinemia, sepsis, convulsion, stillbirth, and condition at discharge were compared to babies who were born to mothers aged 19–21 years and aged 22–30 years. Data were analyzed using frequency, percentage, and Chi-square test.

Definitions used in our study[9]

Small for gestational age

A neonate whose birth weight is <10th percentile for Gestational age or <2 standard deviations below the mean for the infant's gestational age (World Health Organization charts).


  Results Top


In our study, a total of 330 neonates were included, 165 cases and 165 controls, after which the results were obtained using parameters such as gestational age, birth weight, small for gestational age, APGAR score, hyperbilirubinemia, sepsis, asphyxia, convulsion, and stillbirth [Table 1], [Table 2], [Table 3], [Table 4].
Table 1: Comparison of neonates born to young mothers and older mothers with different gestational age

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Table 2: Comparison of neonates born to young mothers and older mothers with respect to birth weight

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Table 3: APGAR Score in neonates born to young mothers and older mothers

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Table 4: Comparison of neonatal outcomes born to young mothers and older mothers

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  Discussion Top


In our study, it was found that sixty babies were born to young mothers in the range of 28–34 weeks as compared to 9 babies in the older mothers. Similar results were found in studies done by Yadav et al. and Kang et al.,[3],[10] proving that young mothers had a higher incidence of preterm deliveries.

It was found that 105 babies born to young mothers were low birth weight as compared to 36 babies in older mothers, implying that young maternal age leads to low birth weight babies.

Sixty-five babies born to young mothers had weight <10th centile as compared to 28 babies in older mothers. Young mothers delivered babies who were small for gestational age. Similar results were found in studies done by Yadav et al. and 4. Restrepo-Méndez et al.[3],[4]

There was no difference found in both the groups in relation to Apgar Score at 1 and 5 min, whereas a study done by Sharma et al. showed low APGAR score (<7) at 1 min in babies born to young mothers as compared to older mothers.[7]

In our study, it was found that ninety newborns born to young mothers required NICU admission as compared to 23 babies in older mothers. Similar results were found in a study done by Ezegwui et al.[11] Young mothers had a higher incidence of babies who were born preterm, low birth weight and in turn had higher chances of asphyxia, stillbirth, and late complications such as sepsis and hypoglycemia which required NICU admissions.

In our study, neonates born to young mothers had a higher incidence of hypoglycemia, sepsis, neonatal hyperbilirubinemia, and convulsions as compared to older mothers. Incidence of asphyxia at birth in both the groups was insignificant. Whereas, in a study done by Chen et al.,[12] it has been reported that the incidence of asphyxia at birth was higher in babies born to young mothers.

The strength of our study is that a large population was involved and it can be applied in the general population.

The weakness of our study was that hypoglycemia, sepsis, and jaundice were the confounding factors and it was related more to gestational age of the baby rather than the mother's age.


  Conclusion Top


Young mothers had a higher incidence of having preterm babies, low birth weight babies with comorbidities, and NICU admissions as compared to older mothers.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Fraser A, Brockert J, Ward R. Association of young maternal age with adverse reproductive outcomes. Stud Fam Plann 1995;26:186-9.  Back to cited text no. 1
    
2.
Kurth F, Bélard S, Mombo-Ngoma G, Schuster K, Adegnika AA, Bouyou-Akotet MK, et al. Adolescence as risk factor for adverse pregnancy outcome in central Africa – A cross-sectional study. PLoS One 2010;5:e14367.  Back to cited text no. 2
    
3.
Yadav S, Choudhary D, Narayan KC, Mandal RK, Sharma A, Chauhan SS, et al. Adverse reproductive outcomes associated with teenage pregnancy. Mcgill J Med 2008;11:141-4.  Back to cited text no. 3
    
4.
Restrepo-Méndez MC, Barros AJ, Santos IS, Menezes AM, Matijasevich A, Barros FC, et al. Childbearing during adolescence and offspring mortality: Findings from three population-based cohorts in Southern Brazil. BMC Public Health 2011;11:781.  Back to cited text no. 4
    
5.
Mukhopadhyay P, Chaudhuri RN, Paul B. Hospital-based perinatal outcomes and complications in teenage pregnancy in India. J Health Popul Nutr 2010;28:494-500.  Back to cited text no. 5
    
6.
International Institute for Population Sciences. National Family Health Surveys, India. Key Findings from NFHS-4. Mumbai: International Institute for Population Sciences; 2015. Available from: http://www.nfhsindia. [Last accessed on 2017 Oct 05].  Back to cited text no. 6
    
7.
Sharma V, Katz J, Mullany LC, Khatry SK, LeClerq SC, Shrestha SR, et al. Young maternal age and the risk of neonatal mortality in rural Nepal. Arch Pediatr Adolesc Med 2008;162:828-35.  Back to cited text no. 7
    
8.
Malviya MK, Bhardwaj VK, Chansoria M, Khare S. Anthropometric profile and perinatal outcome of babies born to young women (<18 years). Indian Pediatr 2003;40:971-6.  Back to cited text no. 8
    
9.
Eric C, Anne R, Camilia R, Ann R. A high risk newborn. Cloherty Starks Man Neonatal Care 2016;1:e79-80.  Back to cited text no. 9
    
10.
Kang G, Lim JY, Kale AS, Lee LY. Adverse effects of young maternal age on neonatal outcomes. Singapore Med J 2015;56:157-63.  Back to cited text no. 10
    
11.
Ezegwui HU, Ikeako LC, Ogbuefi F. Obstetric outcome of teenage pregnancies at a tertiary hospital in Enugu, Nigeria. Niger J Clin Pract 2012;15:147-50.  Back to cited text no. 11
  [Full text]  
12.
Chen XK, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M, et al. Teenage pregnancy and adverse birth outcomes: A large population based retrospective cohort study. Int J Epidemiol 2007;36:368-73.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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