Abstract
Background: Despite rising prevalence of high-risk birth and adverse birth outcome among adolescent mothers in Nigeria, there is paucity of studies relating childhood mortality risk with fertility behaviour of adolescent mothers. This study examines fertility behaviour of adolescent mothers in northern Nigeria and neonatal mortality risk.
 Methods: Data were derived by pooling together the three most recent Nigeria Demographic and Health Surveys (NDHS, 2008, 2013 and 2018). The sample size comprises of weighted sample of 3,739 adolescent mothers 15-19 years with 5, 274 live births for the period under consideration. Survival analysis (cox proportional hazard model) was used to estimate the hazard of neonatal mortality risk as a result of risky fertility behaviour.
 Results: Quality of maternal health service utilization was poor among (73.0%) of the adolescent mothers. The independent effect of adolescent fertility behaviour revealed a rise in hazard for neonatal mortality, with increasing high risk fertility behaviour, single high-risk (HR=2.69, p<0.001) and multiple high risk (HR=6.04, p<0.001). Adjusting for quality of maternal health service utilization, resulted in reduced hazard for neonatal mortality, though the result did not reach statistical significance (p>0.05). Adjusting for maternal, child characteristics and quality of maternal health service utilization, resulted in reduced hazard for neonatal mortality, though, the effect of risky fertility behaviour remained insignificant. Multiple birth babies were however, associated with elevated hazard for neonatal mortality (HR=11.4, p<0.05) relative to single birth babies.
 Conclusion: Adolescent fertility behaviour was associated with elevated hazard for neonatal mortality.
Highlights
The population of young people is apparently rising, especially in developing countries
The socio-demographic characteristics of the women indicates larger percentage (40.4%) of the adolescent mothers were age years, followed by age years (32.7%), while age 15 years accounted for the least proportion (2.4%)
The distribution of the adolescent mothers according to geopolitical zone indicates, higher proportions (56.2%) were residing in the North-west region, followed by North-east (29.0%) region
Summary
The population of young people is apparently rising, especially in developing countries. The demographics of most developing countries indicate adolescents and young people constitute significant proportion of their population. Despite constituting substantial proportion of the population, majority of these young people are faced with barriers to development, making it difficult for them to fulfill their potentials, thereby undermining the prospects to achieving demographic dividend (the growth in an economy driven by changes in the age and education structure of a country’s population) for the host countries, couple with the worrisome reproductive health indices of these young people [2]. Available statistics indicates nothing less than 16 million young adolescent mothers give birth for the first time under 19 years of age. Despite rising prevalence of high-risk birth and adverse birth outcome among adolescent mothers in Nigeria, there is paucity of studies relating childhood mortality risk with fertility behaviour of adolescent mothers. This study examines fertility behaviour of adolescent mothers in northern Nigeria and neonatal mortality risk
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