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Background  Reduced birthweight is associated with adverse physical and mental health outcomes later in life. Children of adolescent mothers are at higher risk for reduced birthweight. The current study aimed to identify the key risk factors affecting birthweight in a well-characterized sample of adolescent mothers to inform preventive public health efforts.    Methods  Sixty-four adolescent mothers (≤ 21 years of age) provided detailed data on pregnancy, birth and psychosocial risk. Separate regression analyses with (1) birthweight and (2) low birthweight (LBW) as outcomes, and pregnancy complications, prenatal care, maternal age, substance abuse during pregnancy, socioeconomic risk, stressful life events and the child’s sex as independent variables were conducted. Exploratively, a receiver operating characteristic (ROC) analysis was performed to investigate the quality of the discriminatory power of the risk factors.    Results  The following variables explained variance in birthweight significantly: prenatal care attendance ( p  = .006), pregnancy complications ( p  = .006), and maternal substance abuse during pregnancy ( p  = .044). Prenatal care attendance ( p  = .023) and complications during pregnancy ( p  = .027) were identified as significant contributors to LBW. Substance abuse ( p  = .013), pregnancy complications ( p  = .022), and prenatal care attendance ( p  = .044) showed reasonable accuracy in predicting low birthweight in the ROC analysis.    Conclusions  Among high-risk adolescent mothers, both biological factors, such as pregnancy complications, and behavioural factors amenable to intervention, such as substance abuse and insufficient prenatal care, seem to contribute to reduced birthweight in their children, a predisposing factor for poorer health outcomes later in life. More tailored intervention programmes targeting the specific needs of this high-risk group are needed.

Pregnancy complications, substance abuse, and prenatal care predict birthweight in adolescent mothers