Teenage childbearing : pregnancy outcomes and long-term consequences for the mothers
Author: Otterblad Olausson, Petra
Date: 2000-01-21
Location: Samuelssonsalen, Scheelelaboratoriet, Tomtebodavägen 6, Karolinska Institutet
Time: 9.00
Department: Institutionen för medicinsk epidemiologi och biostatistik / Department of Medical Epidemiology and Biostatistics
Abstract
The purposes of the thesis were to study effects of low maternal age on
adverse pregnancy outcomes, predictors of teenage childbearing, and
long-term effects of teenage motherhood on the women's social situation
later in life and risk of premature death.
The effects of low maternal age at first birth on risks of adverse
pregnancy outcomes, primarily preterm birth and infant mortality, were
studied in three population-based cohort studies. We used the Swedish
Medical Birth Register, the 1990 Population Census, and the
population-based Education Register. The poorer pregnancy outcomes among
teenagers aged 18-19 years are mainly an effect of a less favourable
socio-economic situation. Infants of younger teenage mothers face an
overall increased risk of preterm birth, neonatal and postneonatal
mortality that is independent of socio-economic situation. The increased
risk of neonatal mortality is entirely an effect of the increased risk of
preterm birth. To study whether the increase in risk of poor pregnancy
outcomes is due to low age per se, we also studied pregnancy outcomes at
second birth in relation to age at first birth. When teenage childbearers
had their second birth in adulthood, the risk of preterm birth has
declined more than the corresponding risk decline among mother who also
had their first birth in adulthood. Our results support the hypothesis
that young age is a risk factor for poor pregnancy outcomes, independent
of socio-economic conditions.
To study familial and environmental effect as predictors of teenage
childbearing, we linked the Swedish Twin Register to the Medical Birth
Register. We used quantitative genetic analyses to evaluate the impact of
genetic and environmental factors on the risk of teenage childbearing. We
estimated the effect of life style factors, socio-economic situation, and
personality traits on the likelihood of teenage childbearing, and if
these factors could explain possible familial effects. Both familial and
other environmental factors are important as predictors of teenage
childbearing. We found significant effects of smoking habits, housing
conditions, and educational level on the risk of teenage childbearing.
However, the familial effect on teenage childbearing was not mediated by
these factors.
In two studies we analysed long-term socio-economic conditions and
premature mortality of teenage mothers. We linked the following
population-based registers: the Population Register, several Censuses,
the Education Register, the Cause of Death Register, and a register of
dependence on social welfare and disability pensions. Teenage
childbearers face a considerably increased risk of a less favourable
situation later in life. They are more likely to be not gainfully
employed, to have an unskilled occupation, to be single mothers, to have
four or five infants, to be dependent on social welfare and receive
disability pensions. Teenage mothers also face an increase in risk of
premature death due to in particular cervical cancer, ischaemic heart
disease, suicide and inflicted violence. The increased risk of as well a
less favourable social situation as premature mortality was independent
of background socioeconomic status.
List of papers:
I. Otterblad Olausson PM, Cnattingius S, Goldenberg RL (1997). "Determinants of poor pregnancy outcomes among teenagers in Sweden" Obstet Gynecol 89: 451-557
II. Otterblad Olausson P, Cnattingius S, Haglund B (1999). "Teenage pregnancies and risk of late fetal death and infant mortality" Br J Obstet Gynaecol 106: 116-121
III. Otterblad Olausson P, Cnattingius S, Haglund B (1970). "Teenage childbearing and pregnancy outcomes in successive births" (Submitted)
IV. Otterblad Olausson P, Lichtenstein P, Cnattingius S (1970). "Aetiology of teenage childbearing: resons for familial effects" Twin Res (In Print)
V. Otterblad Olausson P, Haglund B, Ringbäck Weitoft G, Cnattingius S (1970). "Teenage childbearing and long-term socio-economic consequenses" (Submitted)
VI. Otterblad Olausson P, Haglund B, Ringbäck Weitoft G, Cnattingius S (1970). "Premature death among teenage mothers" (Submitted)
I. Otterblad Olausson PM, Cnattingius S, Goldenberg RL (1997). "Determinants of poor pregnancy outcomes among teenagers in Sweden" Obstet Gynecol 89: 451-557
II. Otterblad Olausson P, Cnattingius S, Haglund B (1999). "Teenage pregnancies and risk of late fetal death and infant mortality" Br J Obstet Gynaecol 106: 116-121
III. Otterblad Olausson P, Cnattingius S, Haglund B (1970). "Teenage childbearing and pregnancy outcomes in successive births" (Submitted)
IV. Otterblad Olausson P, Lichtenstein P, Cnattingius S (1970). "Aetiology of teenage childbearing: resons for familial effects" Twin Res (In Print)
V. Otterblad Olausson P, Haglund B, Ringbäck Weitoft G, Cnattingius S (1970). "Teenage childbearing and long-term socio-economic consequenses" (Submitted)
VI. Otterblad Olausson P, Haglund B, Ringbäck Weitoft G, Cnattingius S (1970). "Premature death among teenage mothers" (Submitted)
Issue date: 1999-12-31
Publication year: 2000
ISBN: 91-628-3953-5
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