The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis
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 out...
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th-mahidol.321542018-10-19T12:16:10Z The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis 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 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 Medicine 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. 2018-10-19T05:16:10Z 2018-10-19T05:16:10Z 2013-09-25 Review BMC Public Health. Vol.13, No.SUPPL.3 (2013) 10.1186/1471-2458-13-S3-S2 14712458 2-s2.0-84884391520 https://repository.li.mahidol.ac.th/handle/123456789/32154 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84884391520&origin=inward |
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Medicine 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 |
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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. |
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Johns Hopkins Bloomberg School of Public Health |
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Johns Hopkins Bloomberg School of Public Health 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 |
format |
Review |
author |
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 |
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Naoko Kozuki |
title |
The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis |
title_short |
The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis |
title_full |
The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis |
title_fullStr |
The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis |
title_full_unstemmed |
The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis |
title_sort |
associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis |
publishDate |
2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/32154 |
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1763495197464854528 |