Abstract

PIP: This discussion addresses the questions of the parinatal, neonatal, and infant health and development of children born to adolescent mothers as related to other biologic and social factors. Medical and legislative plans for adolescent mothers and their infants must be based on assessment of both mortality and morbidity of the infants born to adolescent mothers. Focus here is on neonatal data on 55,711 pregnancies collected by the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke; neonatal data from the University of Kansas Medical Center covering 4000 pregnancies, 770 of which were gestations in teenage mothers; and obstetric, perinatal, and neonatal data concerning 6087 pregnancies in 1976, 1977, and 1978 at the Regional Perinatal Center at the University of Rochester. Ample evidence suggests a strong association between maternal age and birth weight. In particular, Hardy and Mellits found a higher frequency of low birth weight infants born to young black women. Interactions with other variables, including parity, clearly illustrate that firstborn infants are lighter than subsequent infants up to a maternal age of 35. Hoffman et al. have demonstrated that American women 18 years and under show a tendency to have infants of shorter gestational age than women 19-24 years of age. Cigarette smoking, alcohol and drug abuse, prolonged rupture of membranes, seizure disorders, and gonorrhea were significantly more frequently diagnosed in teenage mothers. The studies showed that behavioral and medical complications in the mothers were more powerful determinants of infants born with weight of less than 2500 gm than maternal age alone. In sum, when maternal and fetal growth retarding factors are taken into account among mothers of specific age categories, no biologic disadvantage appears unique to adolescent mothers. Findings fail to support the often expressed view that the mother's biologic immaturity is the main factor responsible for excessive fetal and neonatal deaths in infants born to very young mothers. Proportionately more infants born to adolescent mothers required admission to the intensive care or special care nurseries at the University of Rochester hospital than did infants born to mothers in their 20s (15.77% versus 13.9%). The data suggest that the mothering skills and child rearing practices of adolescent childbearing women have yet to be evaluated adequately.