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Risk of small‐for‐gestational age and preterm among primiparous adolescents in rural Nepal
Author(s) -
Christian Parul,
Katz Joanne,
Stewart Christine P,
Khatry Subarna K,
LeClerq Steven C,
West Keith P
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.4.a615
Subject(s) - medicine , small for gestational age , gestational age , obstetrics , low birth weight , confounding , birth weight , odds ratio , pregnancy , logistic regression , premature birth , pediatrics , genetics , biology
The goal of this analysis was to examine, in a poor rural setting in Nepal, whether young age at first pregnancy increased the risk of low birth weight and whether this was due to an increased risk of intrauterine growth retardation, preterm birth, or both. To address these questions, we used data from a double masked, cluster randomized trial of antenatal supplementation carried out in Sarlahi district, Southern Nepal. Only nulliparous women aged 25 y were included. The rates of low birth weight, preterm birth (gestational age <37 wk) and small‐for‐gestational‐age (sga) were 43%, 59% and 20%. Multivariate logistic regression models were developed for each of these outcomes using maternal age as a continuous independent variable and adjusting for confounders that were associated with both maternal age and the dependent variable. Adjusted odds ratios (95% CL) for low birth weight, sga and preterm were 0.96 (0.90, 1.03), 1.0 (0.95, 1.09) and 0.88 (0.80, 0.96), respectively, indicating that the risk of preterm but not sga decreased with increasing age. Further, we explored the age cut‐off at which the risk of preterm was the highest and found it to be 18 y or less rather than the cut‐off of 19 y commonly used to define adolescence. We conclude that young maternal age during a first pregnancy carries an increased risk of preterm delivery rather than fetal growth retardation, a risk that is no longer evident after 18 y of age. Funded by USAID, Office of Health and Nutrition, Wash DC; Bill & Melinda Gates Foundation, Seattle, and the National Institutes of Health, Bethesda, USA.