Abstract

Background. Typically, infant mortality decreases as maternal age increases in teenagers. In contrast to these national data, San Bernardino County (SBC) experienced a different phenomenon in 1989-1994 among very low birthweight (VLBW) infants. The infant mortality rate (IMR) of VLBW infants born to mothers under 17 years old (283 per 1000 live births) was significantly lower than the IMR of VLBW infants born to mothers between the ages of 17-19 years old (430 per 1000 live births) (p = .02).

Purpose. The purpose of the study was to explain the discrepancy between IMRs of VLBW infants of younger teenage mothers compared to VLBW infants of older teenage mothers in SBC from 1989-1994. In addition, the study determined if the causes of infant mortality differed significantly between VLBW infants of younger mothers compared to VLBW infants of older mothers.

Methodology. This was an observational, population-based study with data examined retrospectively. Records of all VLBW infants who were born between 1989-1994 to teenage mothers in SBC were eligible for inclusion in the study. Study subjects were identified from state and local databases and then data from their hospital records were abstracted.

Analyses. Chi-square analysis was performed on categorical variables to determine if significant differences in risk factors existed between infants of younger mothers compared infants of older mothers when comparing IMRs. Similarly, two-way ANOVAs were performed on continuous variables by maternal age and survival status. Once significant risk factors were identified they were included in a multiple logistic regression analysis model to determine the strongest correlates for infant mortality.

Results. Among VLBW infants of younger mothers (< 17 years old), lower Apgar scores at 5-minutes and lower birthweight were significantly associated with infant mortality. Among VLBW infants of older mothers (17-19 years old), risk factors associated with infant mortality included: lower birthweight, lower Apgar scores at 5-minutes, shorter length of gestation, lack of maternal transport prior to delivery, living alone during pregnancy, and abruptio placenta. No significant differences existed for causes of death among VLBW infants between the two maternal age groups.

Conclusion. This study showed that additional risk factors, beyond birthweight and Apgar scores, predicted mortality in VLBW infants of older teenage mothers and that these infants experience higher rates of mortality when compared to VLBW infants of younger teenage mothers. These data indicate areas to target for preventive care interventions among older teenage mothers in this population to reduce risk of mortality in VLBW infants.

School

School of Public Health

First Advisor

Helen Hopp Marshak

Second Advisor

Susanne B. Montgomery

Third Advisor

Bruce E. Smith

Degree Name

Doctor of Public Health (DrPH)

Degree Level

Ph.D.

Year Degree Awarded

2000

Date (Title Page)

2000

Language

English

Library of Congress/MESH Subject Headings

Infant Mortality -- California -- San Bernardino County; Infant, Very Low Birth weight; Pregnancy in Adolescence

Type

Thesis

Page Count

xiii; 151

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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