Indian Pediatrics

, Volume 53, Issue 10, pp 871–877 | Cite as

Maternal age at childbirth and perinatal and under-five mortality in a prospective birth cohort from Delhi

  • Sikha Sinha
  • Abha Rani Aggarwal
  • Clive Osmond
  • Caroline H. D. Fall
  • Santosh K. Bhargava
  • Harshpal Singh Sachdev
Research Paper



To evaluate the relationship between maternal age at child birth, and perinatal and under-five mortality.


Prospective birth cohort.


Urban community.


9169 pregnancies in the New Delhi Birth Cohort resulted in 8181 live births. These children were followed for survival status and anthropometric measurements at birth (+3 days), 3,6,9 and 12 months (7 days), and every 6 months thereafter until 21 years age. Information on maternal age at child birth and socio-demographic profile was also obtained.

Outcome measures

Offspring mortality from 28 weeks gestation till 5 years age.


Offspring mortality (stillbirths–5 years; n=328) had a U-shaped association with maternal age (P<0.001). Compared to the reference group (20-24 years), younger (≤19 years) and older (≥ 35 years) maternal ages were associated with a higher risk of offspring mortality (HR: 1.68; 95% CI 1.16, 2.43 and HR 1.48; 95% CI 1.01, 2.16, respectively). In young mothers, the increased risk persisted after adjustment for socio-economic confounders (maternal education, household income and wealth; HR 1.51; 95% CI 1.03, 2.20) and further for additional behavioral (place of delivery) and biological mediators (gestation and birthweight) (HR 2.14; 95% CI 1.25,3.64). Similar associations were documented for post-perinatal deaths but for perinatal mortality the higher risk was not statistically significant (P >0.05). In older mothers, the increased mortality risk was not statistically significant (P >0.05) after adjustment for socio-economic confounders.


Young motherhood is associated with an increased risk of post-perinatal mortality and measures to prevent early childbearing should be strengthened.

Key Words

Child mortality Risk factors Teenage pregnancy 


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Copyright information

© Indian Academy of Pediatrics 2016

Authors and Affiliations

  • Sikha Sinha
    • 1
    • 2
  • Abha Rani Aggarwal
    • 3
  • Clive Osmond
    • 4
  • Caroline H. D. Fall
    • 4
  • Santosh K. Bhargava
    • 5
  • Harshpal Singh Sachdev
    • 1
    • 6
  1. 1.Sitaram Bhartia Institute of Science and ResearchNew DelhiIndia
  2. 2.University School of Medicine and Para-medical Health SciencesGuru Gobind Singh Indraprastha UniversityDelhiIndia
  3. 3.National Institute of Medical StatisticsIndian Council of Medical ResearchNew DelhiIndia
  4. 4.MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
  5. 5.Sunder Lal Jain HospitalNew DelhiIndia
  6. 6.Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and ResearchNew DelhiIndia

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