Teenage pregnancy and child health in the urban Sahel

Abstract

Longitudinal data for more than 20,000 live births in the cities of Bamako (Mali) and Bobo-Dioulasso (Burkina Faso) are used to study the effects of young maternal age (less than 18 years and 18-19) on birth weight, child health care and feeding behavior, and child mortality, after controlling for other socioeconomic and demographic factors. Teenage pregnancies are associated with significantly worse prenatal health care and vaccination behavior, lower birth weights, earlier weaning, and, especially during the second year of life, higher mortality. A proxy for mother's school enrollment at the time of pregnancy is strongly linked to worse prenatal health behavior and weakly associated with other poor behaviors and health outcomes. Overall, the results highlight the importance of behavioral factors relative to strictly biological factors for explaining child health differentials.

PIP: Longitudinal data from 2 surveys entitled Enquete sur la Mortalite Infantile dans le Sahel (EMIS), conducted between 1981 and 1985, were used for more than 20,000 live births in the cities of Bamako and Bobo-Dioulasso (Burkina Faso) to study the effects of young maternal age 18 years and 18-19) on birth weight, child health care and feeding behavior, and child mortality, after controlling for other socioeconomic and demographic factors. Multivariate results showed the relative risks for mother's behavior and children's health outcomes by mother's age calculated from the regression results. The estimated probabilities of an event for a child born to mothers of various age groups were divided by the probability for a child of a 25-39 year old mother. The characteristics were: a singleton male of birth order 2-5 living in Bamako with a married, uneducated, non-school-girl mother of low socioeconomic status. The estimated probability that a child born to a mother aged under 18 would receive the full set of diphtheria, pertussis, tetanus (DPT) vaccinations was just 36.2% that of children born to mothers aged 25-39. Babies born to mothers 18 years of age weighed 116 grams less than children of mothers aged 25-39 years, and babies of young mothers were 46% more likely to weigh 2.5 kg. During the 2nd year of life, the mortality risks of these children significantly exceeded those of children born to mothers aged 25-39. Being born to mothers 18 led to 29 additional deaths out of 1000 children having the reference characteristics and to 21 additional deaths compared with children of mothers aged 25-39. School girls were less likely to seek prenatal medical care than were other women and were also less likely to vaccinate their children for DPT. Their children weighed an average of 52 grams less at birth. The results highlight the importance of behavioral factors relative to strictly biological factors for explaining child health differentials.