The association of young maternal age and low socioeconomic status with poor birth outcomes in urban British Columbia
Creators: name: Peet, Konnie C.
Publisher: name: University of British Columbia
Year: 2008

description: The reduction of inequalities in health and longevity have been endorsed by various levels of government, associations of health professionals and others in Canada. Despite the proportional decline in births to women less than 20 years of age in both the United States and Canada, births to young mothers remain of particular interest. Infants born to teenaged mothers have been found to have elevated rates of various poor birth outcomes, which throughout their lives continue to put them at higher risk for poor health and reduced life expectancy. There has been considerable research into the apparent association between young maternal age (MA) and elevated rates of such outcomes as preterm births, low birth weight and infant mortality. There is an equally large body of research that suggests that many of the teenagers having babies live in adverse social and economic circum-stances and that the elevated incidence of various birth outcomes is related to their socioeconomic status (SES). Unfortunately only a small portion of the research has been designed to allow for either the simultaneous analysis of effect of MA and SES or the analysis of a potential association between these two risk factors. Additionally, since the introduction of Medicare there has only been one study which has addressed any of these issues in a Canadian context. This present study was undertaken to investigate the relationships between maternal neighborhood poverty, MA and births outcomes in British Columbia (B.C.). Routinely collected data from the Division of Vital Statistics of the B.C. Ministry of Health and Ministry Responsible for Seniors for 1985 through 1988 was used to obtain maternal, birth and birth outcome data for first single births to 2,738 mothers under 20years and 39,540 women living in Vancouver, Victoria, Kamloops, Kelowna and Prince George. The mother's postal code was used to link summary SES information, provided by Statistics Canada from the census tract of the mother's residence, to the birth related information. Birth data were then ranked by this poverty information and divided into quintiles. There was a significant association between MA and SES with respect to the distribution of births. The percentage of all birth to women under 35 years that occurred to mothers less than 20 years increased from 5.6% in the quintile with the least amount of poverty to 9.7% in that with the highest amount of poverty. Mantel-Haenszel chi-square tests allowed for the assessment of the independent association of each of MA and SES with various birth outcomes. Young MA was found to be a significant risk factor for low birth weight (P&lt;0.001)), infant mortality (P&lt;0.001))and post neonatal mortality (P&lt;0.001). Low SES was found to be significantly associated with increased rates of low birth weight (P&lt;0.001), small for gestational age births(P&lt;0.001) and congenital anomalies (P&lt;0.001). Odds ratios and confidence intervals for these results were also calculated and discussed. The discussion also dealt with research and other implications of these results as well as the potential for the method employed in this study to be a mechanism for tracking secular changes in inequalities in health in British Columbia.