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James P. Guevara, MD, MPH; Josephine C. C. Young, MD, MPH; Beth A. Mueller, DrPH

Arch Pediatr Adolesc Med. 2001;155:66-72.

Objective  To determine the risk of hospitalization associated with prenatal care use and indicators of socioeconomic status and social support among infants of teenage mothers.

Design  Population-based case-control study.

Setting  Nonfederal hospitals in Washington State.

Participants  Infants born from 1987 to 1995 to mothers younger than 20 years were identified using linked birth certificate–state hospital discharge data. Cases consisted of 8052 infants who were hospitalized during the first year of life at least 2 days after birth hospitalization discharge. An equal number of controls, frequency matched on birth year and maternal age group, were randomly sampled from among nonhospitalized infants.

Main Outcome Measure  Hospitalization in the first year of life.

Results  Infants with a father listed on the birth certificate or whose mothers had commercial health insurance had a decreased risk of hospitalization (adjusted odds ratios, 0.91 and 0.78, respectively; 95% confidence intervals, 0.83-0.99 and 0.71-0.85, respectively). Participation in state-funded pregnancy programs, adequacy of prenatal care, or marital status did not affect the risk of hospitalization, except among infants whose mothers received more than adequate prenatal care (adjusted odds ratio, 1.15; 95% confidence interval, 1.03-1.29).

Conclusion  Our results suggest that teenaged mothers who list a father on the birth certificate or who have insurance, indicative of higher socioeconomic status, may have a reduced risk of hospitalization for their infants. Teenaged mothers who receive more than adequate prenatal care may have pregnancy complications that place their infants at increased risk of hospitalization. The effect of these protective factors should be clarified in future studies.

From the Departments of Pediatrics, School of Medicine (Drs Guevara and Young), and Epidemiology, School of Public Health and Community Medicine (Dr Mueller), University of Washington, Seattle.

Corresponding author: James Guevara, MD, MPH, Division of General Pediatrics, Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104.