The Risk of Teen Mothers Having Low Weight Babies: Implications of Recent Medical Research for School Health Personnel

Article excerpt

Medical research investigating the association between young maternal age and the incidence of low birth weight babies has implications for school health personnel. Adolescent females are two times more likely to deliver a low birth weight infant than are adult females,[1] and these infants, weighing less than 2,500 grams or 5.5 pounds at birth, have much higher rates of mortality and morbidity.[2] Low birth weight infants are 40 times more likely to die within the first 28 days than normal birth weight infants.[3] Low birth weight infants also exhibit a much higher incidence of neurological impairment, gross and fine motor dysfunction, and developmental delay.[2]

Other risk factors besides young maternal age affect the likelihood of teen mothers delivering prematurely. Knowledge of these risk factors is important for school health personnel whose daily contact with adolescents gives them a unique opportunity to serve in a premonitory capacity and, in the event of pregnancy, as a source of information for achieving optimal birth outcomes.

A consensus is emerging that any comprehensive model seeking to explain the relationship between low birth weight infants and young maternal age has to include both biological and sociocultural factors.[4] A baby weighing between 2,500 and 3,999 grams is the expected outcome for a pregnant woman with sound physical and mental health. All conditions that compromise an expectant mother's health must be considered when seeking to explain an outcome such as low birth weight. In the United States, teen mothers of color are more likely than other teen-agers to live in low-income households and their care givers are less likely to have a sustained relationship with the health care delivery system.[5]

This article reviews current research on the relationship between low birth weight babies and young maternal age and examines the biological and sociocultural factors that put adolescent females at risk for delivering a low birth weight baby. Recommendations for school health personnel also are presented.

A Medline database search of all articles published in English between January 1991 and December 1997 using the key words "adolescence" and "low birth weight" yielded abstracts of 58 articles. Bibliographies of three recently published university press books on teen-age parents also were consulted to secure saturation across references.[6-8] After eliminating articles that surveyed non-US populations or that did not compare birth outcomes for adolescent and adult subpopulations, 40 articles remained which investigated the incidence of low birth weight among adolescent mothers and/or gave explanations for the young maternal age-low birth weight gradient, that is, the lower the mother's age, the higher the risk of having a low birth weight baby.

INCIDENCE OF LOW BIRTH WEIGHT INFANTS BORN TO ADOLESCENT MOTHERS

The incidence of low birth weight births among adolescent mothers is unquestionably higher among females ages 10-14 than among females ages 15-18. Table 1 is derived from data published by the National Center for Health Statistics in its 1994 Final Natality Statistics Report.[1] Data in Table 1 indicate a U-shaped distribution in the percentage of low birth weight infants across the child-bearing years of women in the United States. Females over age 45 share with females under age 15 a nearly equal risk of having a low birth weight infant.

Table 1
Number and Percent Low Birth Weight
and Live Births, by Age of Mother: United States 1994

                Number
Age of        of Births     Total Live     Percent
Mother         <2,500 g       Births       <2,500 g

  <15            1 766         12,901        13.70
   15            3 527         30,742        11.50
   16            6 502         63,125        10.30
   17            9 685        101,302         9.60
   18           12 526        137,547         9. …