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APHA Scientific Session and Event Listing

Francis A. Obuseh, MS, MPH, Department of Maternal and Child Health, University of Alabama at Birmingham, Ryals Public Health Building 320, 1530 3rd Avenue South, Birmingham, AL 35205-0022, (205) 934-7161, obuseh@uab.edu, BO Blagogee, MD, MPH, PhD, Center for Health Promotion, University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL 35205, and Tolulope T. Aduroja, MD, MPH, Department of Psychiatry, University of Alabama at Birmingham, 1530 3rd Avenue South, Birmingham, AL 35294.

Purpose: We investigated the impact of adolescents' pregnancy on the risk for early mortality outcomes associated with premature rupture of membranes (PROM) among twins.

Methods: Study involved the retrospective cohort study on twins delivered in the United States from 1995 to1998. We computed inter and intra-cluster variation risks for early mortality associated with PROM among twins born within adolescents (<20 years of age) and mature mother (20 -30 years of age) using the generalized estimating equation framework.

Results: A total of 215,212 set of twins were observed, 28,826 adolescents and 186,386 mature mothers. Bivariate analysis showed significant differences in demographic characteristics and neonatal pregnancy outcomes within adolescents and mature mothers (p<0.0001). Adolescents group had more negative pregnancy outcomes which were more than double compared to mature mothers. Adolescents were 1.47 times more likely to have neonatal deaths compared to mature mothers (95% CI: 1.34-1.61). Intra-cluster sources of variation within adolescents showed that twins exposed to PROM had 2.96 (CI: 2.44-3.60), 2.85 (CI: 2.30-3.54) and 2.62 (CI: 1.77-3.86) fold risk for neonatal, early neonatal and late neonatal deaths respectively compared to mature mothers who had 3.55 (CI: 3.23-3.92), 3.68 (CI: 3.32-4.09) and 2.79 (CI: 2.27-3.43) fold risks.

Conclusion: There were higher mortality risks for twins exposed to PROM, intra-cluster variations show that both groups had increased risks between PROM and early mortality indicative that adolescents' age may not be a factor. Higher neonatal mortality in adolescents could be indicative of other factors peculiar to them.

Learning Objectives:

• Participants will be able to
• 1, identify risk factors associated negative birth outcomes in adolescents with twin birth
• 2, assess the level of risk due to premature rupture of the membrane
• 3, identify possible impact of premature rupture of the membrane on birth outcomes
• 4, assess effect of adolescence on premature rupture of the membrane

Keywords: Adolescents, Birth Outcomes

Presenting author's disclosure statement:

Not Answered