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Lara J. Akinbami, MD; Kenneth C. Schoendorf, MD, MPH; John L. Kiely, PhD

Arch Pediatr Adolesc Med. 2000;154:1101-1107.

Background  Previous studies of teenage primiparas have found little or no association between young maternal age and preterm birth. However, the risk of preterm birth in teenage multiparas should not be overlooked because of the high rate of repeat teenage pregnancies.

Objective  To compare the risk of preterm birth in teenage and adult multiparas.

Design  Cross-sectional analysis of US Natality Files, 1990 to 1996.

Methods  We calculated the risk of very preterm birth (<33 weeks' gestation) for multiparas aged 10 to 20 years compared with 25-year-olds, stratified by age and race/ethnicity. Adjusted odds ratios (AORs) were estimated controlling for maternal education, marital status, prenatal care, and previous preterm births. Effects of smoking and interpregnancy interval were analyzed separately.

Results  Throughout adolescence, multiparas face higher AORs for very preterm births. For white non-Hispanic multiparas compared with 25-year-old multiparas, 10- to 14-year-olds had an AOR of 4.22 (95% confidence interval [CI], 2.26-7.88), 15- to 17-year-olds had an AOR of 2.19 (95% CI, 1.99-2.42), 18- and 19-year-olds had an AOR of 1.69 (95% CI, 1.58-1.80), and 20-year-olds had an AOR of 1.33 (95% CI, 1.24-1.41). A similar pattern of decreasing AOR with increasing maternal age was observed for black non-Hispanic and Hispanic mothers, although wide race/ethnicity disparities exist. Adjusting for maternal smoking and short interpregnancy interval did not change these results.

Conclusions  Risk of very preterm birth in teenage multiparas is associated with young age after controlling for other risk factors. Interventions to prevent repeat pregnancies and the associated risk of premature birth deserve high priority.

From the Infant and Child Health Studies Branch, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md (Drs Akinbami and Schoendorf), and the Child Health Statistics Center, University of Cincinnati Medical Center, Cincinnati, Ohio (Dr Kiely).

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