Publication:
The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis

Issued Date

2013-09-25

Resource Type

Review

ISSN

14712458

DOI

10.1186/1471-2458-13-S3-S2

Other identifier(s)

2-s2.0-84884391520

Rights

Mahidol University

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SCOPUS

Bibliographic Citation

BMC Public Health. Vol.13, No.SUPPL.3 (2013)

Suggested Citation

Naoko Kozuki, Anne Cc Lee, Mariangela F. Silveira, Ayesha Sania, Joshua P. Vogel, Linda Adair, Fernando Barros, Laura E. Caulfield, Parul Christian, Wafaie Fawzi, Jean Humphrey, Lieven Huybregts, Aroonsri Mongkolchati, Robert Ntozini, David Osrin, Dominique Roberfroid, James Tielsch, Anjana Vaidya, Robert E. Black, Joanne Katz The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis. BMC Public Health. Vol.13, No.SUPPL.3 (2013). doi:10.1186/1471-2458-13-S3-S2 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/32154

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Title

The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis

Author(s)

Naoko Kozuki
 Anne Cc Lee
 Mariangela F. Silveira
 Ayesha Sania
 Joshua P. Vogel
 Linda Adair
 Fernando Barros
 Laura E. Caulfield
 Parul Christian
 Wafaie Fawzi
 Jean Humphrey
 Lieven Huybregts
 Aroonsri Mongkolchati
 Robert Ntozini
 David Osrin
 Dominique Roberfroid
 James Tielsch
 Anjana Vaidya
 Robert E. Black
 Joanne Katz

Other Contributor(s)

Johns Hopkins Bloomberg School of Public Health
 Brigham and Women's Hospital
 Universidade Federal de Pelotas
 Harvard School of Public Health
 University of Western Australia
 Organisation Mondiale de la Sante
 The University of North Carolina at Chapel Hill
 Centro
 Zvitambo
 Universiteit Gent
 Prins Leopold Instituut voor Tropische Geneeskunde
 Mahidol University
 UCL Institute of Child Health

Abstract

Background: Previous studies have reported on adverse neonatal outcomes associated with parity and maternal age. Many of these studies have relied on cross-sectional data, from which drawing causal inference is complex. We explore the associations between parity/maternal age and adverse neonatal outcomes using data from cohort studies conducted in low- and middle-income countries (LMIC). Methods. Data from 14 cohort studies were included. Parity (nulliparous, parity 1-2, parity ≥3) and maternal age (<18 years, 18-<35 years, ≥35 years) categories were matched with each other to create exposure categories, with those who are parity 1-2 and age 18-<35 years as the reference. Outcomes included small-for-gestational-age (SGA), preterm, neonatal and infant mortality. Adjusted odds ratios (aOR) were calculated per study and meta-analyzed. Results: Nulliparous, age <18 year women, compared with women who were parity 1-2 and age 18-<35 years had the highest odds of SGA (pooled adjusted OR: 1.80), preterm (pooled aOR: 1.52), neonatal mortality (pooled aOR: 2.07), and infant mortality (pooled aOR: 1.49). Increased odds were also noted for SGA and neonatal mortality for nulliparous/age 18-<35 years, preterm, neonatal, and infant mortality for parity ≥3/age 18-<35 years, and preterm and neonatal mortality for parity ≥3/≥35 years. Conclusions: Nulliparous women <18 years of age have the highest odds of adverse neonatal outcomes. Family planning has traditionally been the least successful in addressing young age as a risk factor; a renewed focus must be placed on finding effective interventions that delay age at first birth. Higher odds of adverse outcomes are also seen among parity ≥3 / age ≥35 mothers, suggesting that reproductive health interventions need to address the entirety of a woman's reproductive period. Funding. Funding was provided by the Bill & Melinda Gates Foundation (810-2054) by a grant to the US Fund for UNICEF to support the activities of the Child Health Epidemiology Reference Group. © 2013Kozuki et al; licensee BioMed Central Ltd.

Keyword(s)

Medicine

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https://repository.li.mahidol.ac.th/handle/20.500.14594/32154

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