Inner-City Teenagers are at Higher Risk of Preterm Delivery for their Second Birth than for their First

Abstract

A retrospective study investigated a sample of 737 low-income inner-city women (80% Black and 20% White) who as adolescents had received prenatal care during two pregnancies at the Jefferson County Health Department and at the University of Alabama at Birmingham and who had given birth between January 1983 and February 1990. Nearly 37% of these women had had their first birth before age 16 and 87% had had their first birth before age 18. 71% of the births were to 18-19 year olds. The frequency of fetal growth retardation mean birth weight preterm delivery and perinatal mortality were analyzed. The level of fetal growth retardation among infant born to young inner-city women who had already had a growth-retarded child was 12.5% for Blacks and 18.2% for Whites. In contrast among adolescents whose first child was within the normal weight range only 3.4% of Blacks and 2.9% of Whites subsequently delivered a growth-retarded child. Overall the mean infant birth weight was 91 g greater among the second-born children (3107 g) than among the first-born (3016 g). Multivariate regression analysis revealed that this increase in mean birth weight according to parity was significantly associated with an increase in the womens prepregnancy body mass index (p < .03). However the rate of preterm delivery was greater in the adolescents second pregnancy than in their first: the overall incidence of preterm delivery rose significantly from 15% in the first pregnancy of 19% in the second. Among adolescents who delivered preterm in their first pregnancy 49% of Blacks and 32% of Whites also had a preterm birth in their second pregnancy. While the rate of premature births did not rise among While teenagers between their first and second pregnancies it increased from 15% to 21% among the Black teenage mothers. The White adolescents showed no sign of an increase despite their higher use of tobacco alcohol or illicit drugs during both pregnancies.