The impact of young maternal age at birth on neonatal mortality: Evidence from 45 low and middle income countries

ObjectivesThis study explores the impact of early motherhood on neonatal mortality, and how this differs between countries and regions. It assesses whether the risk of neonatal mortality is greater for younger adolescent mothers compared with mothers in later adolescence, and explores if differences reflect confounding socio-economic and health care utilisation factors. It also examines how the risks differ for first or subsequent pregnancies.MethodsThe analysis uses 64 Demographic and Health Surveys collected between 2005 and 2015 from 45 countries to explore the relationship between adolescent motherhood (disaggregated as FindingsThe risk of neonatal mortality in all regions was markedly greater for infants with mothers under 16 years old, although there was marked heterogeneity in patterns between regions. Adjusting for socio-economic, demographic and health service utilisation variables did not markedly change the odds ratios associated with age. The increased risks associated with adolescent motherhood are lowest for first births.ConclusionOur findings particularly highlight the importance of reducing adolescent births among the youngest age group as a strategy for addressing the problem of neonatal mortality, as well ensuring pregnant adolescents have access to quality maternal health services to protect the health of both themselves and their infants. The regional differences in increased risk are a novel finding which requires more exploration.

研究目标
本研究旨在探讨青春期早育对新生儿死亡率的影响，以及该影响在不同国家与地区间的异质性。研究评估了相较于青春晚期母亲，低龄青春期母亲的新生儿死亡风险是否更高，并探究此类差异是否由混杂的社会经济与医疗服务利用因素所导致。此外，本研究还考察了首次妊娠与后续妊娠中，该死亡风险的差异情况。
方法
本分析采用2005年至2015年间45个国家的64项人口与健康调查（Demographic and Health Surveys）数据，以探究青春期母亲群体与新生儿死亡率之间的关联，并对青春期母亲群体进行细分。
研究结果
所有地区中，母亲年龄不足16岁的新生儿其新生儿死亡风险均显著更高，尽管各地区的死亡模式存在显著异质性。对社会经济、人口统计学与医疗服务利用相关变量进行调整后，与母亲年龄相关的优势比（odds ratios）并未出现明显变化。青春期早育相关的死亡风险升高现象，在首次分娩中表现得最为轻微。
结论
本研究结果特别强调，作为应对新生儿死亡率问题的策略，降低最低龄青春期群体的生育行为至关重要；同时还应确保妊娠青春期女性能够获得优质的孕产妇保健服务，以保护其自身与新生儿的健康。本次研究发现的风险升高程度的地区差异是一项新颖的结论，有待进一步探索。