Objectives Explore associations between maternal and neonatal outcomes and maternal age, with particular reference to adolescent women.
Design Population-based cohort study.
Setting Maternity department of a large hospital in Northern England.
Participants Primiparous women delivering a singleton at Bradford Royal Infirmary between March 2007 and December 2010 aged ≤19 years (n=640) or 20–34 years (n=3951). Subgroup analysis was performed using women aged ≤16 years (n=68). Women aged 20–34 years were used as the reference group.
Primary outcome measures Maternal and neonatal outcomes.
Results The odds of extremely low birth weight (<1000 g) were significantly higher in the adolescent group (≤19 years) compared with the reference group (adjusted OR (aOR) 4.13, 95% CI 1.41 to 12.11). The odds of very (<32 weeks) and extremely (<28 weeks) preterm delivery were also higher in the adolescent group (aOR 2.12, 95% CI 1.06 to 4.25 and aOR 5.06, 95% CI 1.23 to 20.78, respectively).
Women in the adolescent group had lower odds of gestational diabetes (aOR 0.35, 95% CI 0.20 to 0.62), caesarean delivery (aOR 0.53, 95% CI 0.42 to 0.67 and instrumental delivery (aOR 0.53, 95% CI 0.41 to 0.67).
Conclusions This study identifies important differences in maternal and neonatal outcomes between women by age group. These findings could help in identifying at-risk groups for additional support and tailored interventions to minimise the risk of adverse outcomes for these vulnerable groups. Further work is needed to identify the causal mechanisms linking age with outcomes in adolescent women where significant gaps in the literature exist.
- born in Bradford
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Contributors KM-D: completion of data analysis and responsible for writing the manuscript. KK: providing specialist input on statistical methods. VJB: providing specialist input on methods and structure, providing comments and making amendments to the manuscript. HS: providing specialist input on methods and structure, providing comments and making amendments to the manuscript.
Funding The research wasfunded by the NIHR CLAHRC Yorkshire and Humber through the White Rose PhD studentship network. The views expressedare those of the author(s), and not necessarily those of the NHS, the NIHR orthe Department of Health and Social Care. The Born in Bradford study presents independent research commissioned by the National Institute for Health Research Collaboration for Applied Health Research and Care (NIHR CLAHRC) and the Programme Grants for Applied Research funding scheme (RP-PG-0407-10044).
Disclaimer The views and opinions expressed are those of the authors, and not necessarily those of the NHS, the NIHR or the Department of Health.
Competing interests None declared.
Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Ethics approval Ethical approval for the study was granted by Bradford Research Ethics Committee (ref no. 07/H1302/112).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Requests for access to data should be addressed to the corresponding author or to the Born in Bradford programme manager firstname.lastname@example.org.
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