Infants Of Adolescent Mothers Research Articles

Revisit the correlates of infant mortality in Bangladesh: findings from two nationwide cross-sectional studies

ObjectiveThe main objective of this study is to investigate how the direction and strength of the association between infant mortality and its predictors are changing over time in Bangladesh using...

Infant carrying as a tool to promote secure attachments in young mothers: Comparing intervention and control infants during the still-face paradigm

Infants of adolescent mothers have a greater risk of developing insecure attachment types and attachment disorders into adulthood. Previous research suggests that skin-to-skin contact predicts secure attachment; however, it is largely unknown whether infant carrying or “babywearing” has similar benefits. We hypothesized that adolescent mothers (Mage=19.1 years, SD = 2.0; 40.6 % Hispanic; 40 %< = 11th grade) who were randomly assigned to an infant carrying condition at 2–4 weeks’ post-partum (n = 16; 1 h daily for 3 months), compared to a control group (n = 17; reading), would be more likely to have securely attached infants at 7 months (M = 29.0 weeks, SD = 3.4). We coded infant gaze orientation, fretfulness, affect, self-soothing behaviors, and vocalizations in the reunion phase of the Still-Face Paradigm, and used an algorithm derived from the infant Global Rating Scales to determine attachment type. Infants in the intervention condition were more likely to have secure attachments and less likely to have disorganized attachments compared to the control condition. Hours spent babywearing was positively correlated with secure attachment, rpb = .40, and negatively correlated with disorganized attachment, rpb =−0.36. There were no statistically significant differences between the conditions or babywearing hours for avoidant or resistant attachment types. The results suggest that infant carrying may be an effective tool at promoting secure attachments, particularly for mothers and infants at greater risk for attachment insecurity.

Exploring Differences Between Adolescents and Adults With Perinatal Depression-Data From the Expanding Care for Perinatal Women With Depression Trial in Nigeria.

Background: Depression is common among women in the perinatal period. Although pregnancy and motherhood among adolescents are global public health issues, little is known about how adolescents differ from adults in the occurrence and correlates of perinatal depression.Methods: Data were derived from a cluster randomized controlled trial of psychosocial interventions for perinatal depression in primary maternal care in Nigeria (the Expanding Care for Perinatal Women with Depression trial). Adolescents and adult participants recruited during pregnancy and followed up till 6-month postpartum were compared: proportions with depression [screening positive to depression on the Edinburgh Postnatal Depression Scale (score ≥ 12) and meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria using the short form of the Composite International Diagnostic Interview]; adjustment and attitude to pregnancy and motherhood (using the Maternal Adjustment and Maternal Attitudes scale); and parenting skills (measured on Infant–Toddler version of the Home Inventory for Measurement of the Environment). Infant and fetal growth were assessed by measures of weight and head circumference at birth and upper mid-upper arm circumference (MUAC) at 6 months.Results: Of 8,580 adults screened, 6.9% had major depression compared with 17.7% of 772 screened adolescents (p < 0.001). Adolescents had significantly poorer adjustment and attitudes to pregnancy, lower mean fetal gestational age at birth, and a smaller mean baby’s birth weight. At 6-month postpartum, there were no significant differences in the rates of remission from depression between adolescent and adult women (Edinburgh Postnatal Depression Scale score <6). Adolescent mothers continued to have poorer maternal attitudes and parenting skills indicated by significantly lower scores on the Infant–Toddler version of the Home Inventory for Measurement of the Environment responsivity and involvement subscales. Infants of adolescent mothers had a higher rate of undernutrition (defined as MUAC < 12.5 cm) compared with those of adult mothers: 14.8 and 6.3%, respectively (p = 0.008), with the mean MUAC remaining significantly lower for infants of adolescent mothers after adjusting for their lower birth weight (p = 0.04).Conclusion: Perinatal depression is more common and is associated with poorer maternal attitudes and parenting skills in adolescents compared with those in adults. Evidence from this exploratory study suggests that in improving outcomes in infants of adolescent mothers with perinatal depression, depression treatment may need to be supplemented with specific approaches to improve parenting skills.

A longitudinal cohort study of\xa0rural adolescent vs adult South African mothers and their children from birth to 24\u2009months

BackgroundAdolescent motherhood has been repeatedly linked to poor child outcomes in high income countries and urban areas in low- and middle-income countries. We examine the structural, personal, and caretaking challenges of adolescent mothers and their children in rural South Africa compared to adult mothers over the first 24 months post-birth.MethodsA cohort of sequential births (n = 470/493) in the rural OR Tambo District was recruited and reassessed at 3, 6, 9, 12, and at 24 months post-birth, with a retention rate above 84% at all timepoints. Maternal and child outcomes were examined over time using multiple linear and logistic regressions.ResultsAdolescent mothers reflect 17% of births (n = 76/458). Adolescent mothers were more likely to have water in their households, but less likely to live with a partner and to be seropositive for HIV than adult mothers. Risks posed by mental health symptoms, alcohol, and partner violence were similar. Adolescents exclusively breastfed for shorter time and it took longer for them to secure a child grant compared to adult mothers. Although obtaining immunizations was similar, growth was significantly slower for infants of adolescent mothers compared to adult mothers over time.ConclusionsIn rural South Africa, almost one in five pregnant women is an adolescent. Caretaking tasks influencing child growth, especially breastfeeding and securing the child grant appear as the greatest problems for adolescent compared to adult mothers.

The nutrition and health risks faced by pregnant adolescents: Insights from a cross-sectional study in Bangladesh.

Little is known about nutrition and well-being indicators of pregnant adolescents and the availability and use of nutrition interventions delivered through maternal, newborn, and child health (MNCH) programs. This study compared the differences between pregnant adolescents and adult pregnant women in services received, and in maternal and child nutrition and health conditions. A survey of 2,000 recently delivered women with infants <6 months of age was carried out in 20 sub-districts in Bangladesh where MNCH program is being implemented. Differences in service use and outcomes between pregnant adolescents and adult women were tested using multivariate regression models. The coverage of antenatal care and nutrition services was similar for adolescent and adult mothers. Compared to adult mothers, adolescent mothers had significantly fewer ownership of assets and lower decision making power. Adolescent mothers weighed significantly less than adult women (45.8 vs 47.1 kg, p = 0.001), and their body mass index was significantly lower (19.7 vs 21.3, p = 0.001). Adolescents recovered later and with greater difficulty after childbirth. Infants of adolescent mothers had significant lower height-for-age z-score (-0.89 vs -0.74, p = 0.04), lower weight-for age z-score (-1.21 vs -1.08, p = 0.02) and higher underweight prevalence (22.4% vs 17.9%, p = 0.04) compared to infants of adult women. In conclusion, this study confirms that adolescent pregnancy poses substantial risks for maternal and infant outcomes, and emphasizes that these risks are significant even where services during pregnancy are available and accessed. A focus on preventing adolescent pregnancy is imperative, while also strengthening health and nutrition services for all pregnant women, whether adult or adolescent.

Desenvolvimento motor e cognitivo de bebês de mães adolescentes e adultas: estudo longitudinal

The aims of this study were to investigate in infants of adolescent and adult mothers: (1) the risk factors for child development; (2) changes in cognitive and motor development over four months of follow-up, (3) correlation between cognitive and motor development over four months of follow-up. This is a longitudinal study with 40 infants, 20 infants of adolescent mothers and 20 of adult mothers from Porto Alegre and Butia, state of Rio Grande do Sul, Brazil. Three evaluations of motor and cognitive development were performed using the Alberta Motor Infant Scale (AIMS) and the Bayley Scale Infant Development II. Significant difference in the supine position of AIMS was observed between groups in the third evaluation. Infants of adolescent mothers showed lower scores than those of adult mothers. The motor scores of each position and total AIMS score showed significant difference during overall time and in each group. The Bayley-II mental score also showed significant difference during overall time and in each group. There was a positive, strong and significant association between AIMS and Bayley scores in all three evaluation stages as in the group of infants of adolescent and adult mothers. It was concluded that infants of adolescent mothers showed worse results in the supine position during the third evaluation than those of adult mothers. There was a significant association between motor and cognitive development in both groups of infants over time.

120. Adolescent mothers and their children: Outcomes of a Tots and Teens program in a Canadian urban setting

sexual, 36% physical and 18% emotional). Thirty percent of mothers had child protection involvement in their own childhoods. The majority of adolescent mothers were living with family (54%), or in a maternity home (28%); 71% resided in lower SES neighborhoods. Forty-four percent of our adolescent mothers reported a history of substance use (tobacco 27%, marijuana 27% and alcohol 19%). Only sixty percent were attending school or had graduated high school prior to the birth of their child. A significant proportion of children in our population experienced expressive speech and language delay (47%) and poor growth (24%) by 18 months of age. Child protection services became involved with 65% of our families, primarily for instrumental support, concerns regarding parenting capacity, or due to intimate partner violence. Conclusions: The Young Families Program is an interprofessional family-centred program acting as the “medical home” for parenting adolescents and their children. This population is challenged by a significant burden of preexisting maternal mental health issues, maternal trauma history, maternal substance use, delayed educational attainment and residing in low SES neighborhoods. A significant number of infants of adolescentmothers in our samplewere at risk for delayed language development and poor growth. Comprehensive programs focusing on the unique needs of this population should endeavor to enhance the overall health and wellbeing of both the adolescent mother and her children, with a specific focus on maternal and infant mental health through both dyad and individual therapy, child growth and development including access to consistent caregiving in a stimulating, structured environment, instrumental support with securing safe, clean housing, educational issues, and effective liaison with child protection services. Sources of Support: Social Pediatrics Research Summer Scholarship (SPReSS) Funding, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada.

P-871 - Psycho-pathological disorders in teenage mothers: implications in the process of mother-child bond

Portugal is the second country in Europe with a greater number of cases of teenage pregnancy, and this fact associated with the onset of many disorders psycho-pathology in this age group (INE, 2009). Against this background, this research aims to evaluate the response of social withdrawal in infants of adolescent mothers with depression and anxiety, three months after delivery. As tools to be used Bonding Scale, The Alarm Distress Bebe Scale (ADBB), the Postpartum Depression Screening Scale (PDSS) and the Inventory of State-Trait Anxiety (STAI). The sample of this research will consist of approximately 150 teenage mothers and their babies living in the central region of Portugal.The major goal behind this research project is that it be implemented in order to allow for future empirical contributions targeted strategies for the prevention of depression and anxiety in the postpartum period in adolescence, supported the preparation of manuals of good practice.

Prenatal tobacco exposure is related to neurobehavioral modifications in infants of adolescent mothers

INTRODUCTION:Prenatal tobacco exposure interferes with neonatal outcomes.OBJECTIVE:To determine the neonatal neurobehavioral effects of in utero tobacco exposure.METHODS:This prospective cross-sectional study included healthy, term, with birth weight appropriate for gestacional age neonates without exposure to alcohol, drugs, or infections, born to adolescent mothers without psychiatric disorders or post-traumatic stress. Infants were classified according to in utero tobacco exposure, as identified by the Composite International Diagnostic Interview administered to mothers. Neurobehavior was assessed by the Neonatal Intensive Care Unit Network Neurobehavioral Scale. Both tools were administered between 24 and 72 hours after birth. Neurobehavioral outcomes were compared between exposed and non-exposed infants by ANOVA. The associations between neurobehavioral scores and number of cigarettes smoked were studied by linear correlation.RESULTS:During the study, 928 newborns of adolescent mothers were born, and 388 were included in the study. Of these, 23 were exposed to tobacco, and 365 neonates were not exposed. There were no differences between the groups in gestational age, birth weight, post-natal age at the exam, or time between last feeding and exam. Exposed neonates showed higher scores on arousal (p = 0.004), excitability (p = 0.003), and stress/abstinence signals (p = 0.019) and a lower score on regulation (p = 0.025). After adjusting for the type of anesthesia, mode of delivery, gender, age at neurologic exam, exam duration and time between last feeding and exam, differences in arousal and excitability remained significant. The mean number of cigarettes consumed daily was positively correlated with lethargy (p = 0.013) and inversely with attention (p = 0.043).CONCLUSIONS:Neonates exposed in utero to tobacco showed worse neurobehavioral performance between 24 and 48 hours of life.

A Review of Attachment Theory in the Context of Adolescent Parenting

The purpose of this article is to review attachment theory and relate the attachment perspective to adolescent mothers and their children. Attachment theory explains positive maternal-infant attachment as a dyadic relationship between the infant and mother that provides the infant with a secure base from which to explore the world. With respect to cognitive, social, and behavioral domains, securely attached infants tend to have more favorable long-term outcomes, while insecurely attached infants are more likely to have adverse outcomes. Adolescent parenthood can disrupt normal adolescent development, and this disruption influences development of the emotional and cognitive capacities necessary for maternal behaviors that foster secure attachment. However, it appears that if specialized supports are in place to facilitate the process of developing attachment, infants of adolescent mothers can obtain higher rates of secure attachment than normative samples in this population.

Associations Between Maternal Age and Infant Health Outcomes Among Medicaid-Insured Infants in South Carolina: Mediating Effects of Socioeconomic Factors

The objective of this study was to investigate whether infants who are born to adolescent mothers are at greater risk for health problems than those who are born to older mothers. Data represent all health care encounters for infants who were born in South Carolina between 2000 and 2002 and were healthy at birth and continuously enrolled in fee-for-service Medicaid (n = 41696). We separately examined in the first and second years of life use of preventive care doctor visits, sick-infant doctor visits, emergency department visits, hospital admissions, and both emergency department visits and hospitalizations for ambulatory care-sensitive conditions. We compared these outcomes for infants of adolescent mothers (aged 11-17 years) and older mothers (aged 18-47 years), adjusting for individual characteristics of mothers and infants. In unadjusted results, infants of adolescent mothers used more health care in 9 of 12 use categories. For example, in year 1, they had an average of 1.71 emergency department visits and 1.39 hospitalizations, compared with 1.26 and 1.18, respectively, for infants of older mothers. In results that were adjusted only for infant and delivery characteristics, they similarly used more services in most categories. After adjustment for either mothers' characteristics alone or those of both the infant/delivery and mothers, there was evidence that they had modestly more sick-infant doctor visits and hospital admissions in year 1 and notably more hospital admissions for ambulatory care-sensitive conditions. Infants of adolescent mothers are more likely than infants of older mothers to use a variety of health care services that suggest poorer health. A considerable proportion of this greater use seems to be attributable to specific characteristics of mothers, such as socioeconomic characteristics, rather than to an inability that is common among adolescents to promote infant health or to use health care appropriately.

Factors predicting attachment patterns in infants of adolescent mothers

The aim of the current study was to examine predictors of the mother-infant attachment relationship in adolescent mother-infant dyads. Seven factors were investigated: Maternal adult attachment style, childhood maltreatment history, depression, parenting stress and sensitivity; infant temperament difficulty; and social support. The sample consisted of138 dyads. Predictive factors were measured during pregnancy, and at four and ten months, whereas attachment was evaluated at fifteen months using the Strange Situation procedure. Results indicated that the secure infants' mothers expressed less parenting stress and more satisfaction with social support as compared to mothers of avoidant or resistant infants. Moreover, these mothers completed more years of schooling than mothers of avoidant, resistant or disorganised infants. Contrary to our expectations, it was found that neither maternal sensitivity, nor adult attachment style contributed to the prediction of attachment patterns. Furthermore, disorganised attachments were not predicted by more severe constellations of risk factors. These findings are discussed in relation to the particular ecology of adolescent mothers.

The Association of Major Depression, Conduct Disorder, and Maternal Overcontrol with a Failure to Show a Cortisol Buffered Response in 4-Month-Old Infants of Teenage Mothers

Adolescent pregnancy can be associated with major depression (MD) and conduct disorder (CD). Some infants of adolescent mothers are prenatally exposed to these factors, which may result in heightened risk for perturbations of their stress systems. Between 2 and 4 months, a normal shift occurs in the adrenocortical system in which we observe a marked decrease in infant cortisol response when facing mild stressors. This study aimed to explore whether MD (lifetime, during pregnancy, postpartum), CD, and maternal overcontrol are associated with increased cortisol reactivity in 4-month-old infants of teenage mothers. Using arm restraint as a stressor, morning salivary cortisol was taken prestressor and poststressor in 212 infants during a laboratory visit. Major depression and CD were measured with the computerized National Institute of Mental Health Diagnostic Interview Schedule (NIMH-DIS), postpartum depressive mood was measured with the Edinburgh Postnatal Depression Scale, and overcontrol was observed with the CARE-Index. Independent of the predictors, there was a dampened cortisol response. Infants of mothers with lifetime MD and of average to highly overcontrolling mothers showed increased cortisol reactivity. Conduct disorder and cortisol levels were not associated. Future studies should detect whether the absence of a dampened cortisol response in infants whose mothers have lifetime MD or display overcontrolling parenting is stable over time.

Determinants of neonatal and post-neonatal mortality in the City of São Paulo

INTRODUCTION: Child Mortality (mortality of children less than five years) has declined considerably in the developing world in the 1990s, but the Infant Mortality has declined less. Therefore, to further reduce child mortality it is important to understand the determinants of neonatal and post-neonatal mortality. MATERIAL AND METHODS: We probabilistically matched 209628 live births and 3842 infant death records from the City of São Paulo, birth cohort of 1998. Data came from SINASC and SIM. We then used logistic regression to analyze the following risk factors of neonatal and post-neonatal mortality: birth weight, gestational age, Apgar scores at 1 and 5 minutes, delivery mode, plurality, sex, maternal education, maternal age, number of prior losses, prenatal care, race, parity and community development. RESULTS AND CONCLUSION: Infants of older mothers were less likely to die in the neonatal period; infants of adolescent mothers were more likely to die in both periods. Parities four or higher increased the likelihood of post-neonatal death. Cesarean delivery was not found to be associated with infant mortality. Low number of prenatal care visits, low birth weight, preterm birth and low Apgar scores were associated with neonatal death; Low number of prenatal care visits, low birth weight, and low Apgar scores were associated with post-neonatal death. Finally, having a mother live in a highest developed community decreased the likelihood of infant death, suggesting that unmeasured factors are behind such association.

Care for adolescent pregnancy and childbirth

The rise in adolescent pregnancy in the 20th century has been influenced by declining age at menarche, increased schooling, delay of marriage, inadequate contraception and poverty. The main problems are preterm labor, hypertensive disease, anemia, more severe forms of malaria, obstructed labor in very young girls in some regions, poor maternal nutrition and poor breastfeeding. In many regions HIV infection is an important problem. The infants of adolescent mothers are more prone to low birth weight and increased neonatal mortality and morbidity. Antenatal care is often inadequate. The most important problem is the increased incidence of preterm labor and delivery, the youngest age groups running the highest risk. Technically, care of adolescents during labor need not differ from care of older women; most adolescents are not at increased risk during labor, although, they are more in need of empathic support. Generally, care of pregnant adolescents should be adjusted to their specific needs.

Adult attachment and maternal perceptions of toddler temperament and emotion

Infants of adolescent mothers have a greater risk of developing insecure attachment types and attachment disorders into adulthood. Previous research suggests that skin-to-skin contact predicts secure attachment; however, it is largely unknown whether infant carrying or “babywearing” has similar benefits. We hypothesized that adolescent mothers (Mage=19.1 years, SD = 2.0; 40.6 % Hispanic; 40 %< = 11th grade) who were randomly assigned to an infant carrying condition at 2–4 weeks’ post-partum (n = 16; 1 h daily for 3 months), compared to a control group (n = 17; reading), would be more likely to have securely attached infants at 7 months (M = 29.0 weeks, SD = 3.4). We coded infant gaze orientation, fretfulness, affect, self-soothing behaviors, and vocalizations in the reunion phase of the Still-Face Paradigm, and used an algorithm derived from the infant Global Rating Scales to determine attachment type. Infants in the intervention condition were more likely to have secure attachments and less likely to have disorganized attachments compared to the control condition. Hours spent babywearing was positively correlated with secure attachment, rpb = .40, and negatively correlated with disorganized attachment, rpb =−0.36. There were no statistically significant differences between the conditions or babywearing hours for avoidant or resistant attachment types. The results suggest that infant carrying may be an effective tool at promoting secure attachments, particularly for mothers and infants at greater risk for attachment insecurity.

Mother-infant attachment security, mothers' interactive style, and infants' communicative, symbolic, and social-affective functioning

Infants of adolescent mothers have a greater risk of developing insecure attachment types and attachment disorders into adulthood. Previous research suggests that skin-to-skin contact predicts secure attachment; however, it is largely unknown whether infant carrying or “babywearing” has similar benefits. We hypothesized that adolescent mothers (Mage=19.1 years, SD = 2.0; 40.6 % Hispanic; 40 %< = 11th grade) who were randomly assigned to an infant carrying condition at 2–4 weeks’ post-partum (n = 16; 1 h daily for 3 months), compared to a control group (n = 17; reading), would be more likely to have securely attached infants at 7 months (M = 29.0 weeks, SD = 3.4). We coded infant gaze orientation, fretfulness, affect, self-soothing behaviors, and vocalizations in the reunion phase of the Still-Face Paradigm, and used an algorithm derived from the infant Global Rating Scales to determine attachment type. Infants in the intervention condition were more likely to have secure attachments and less likely to have disorganized attachments compared to the control condition. Hours spent babywearing was positively correlated with secure attachment, rpb = .40, and negatively correlated with disorganized attachment, rpb =−0.36. There were no statistically significant differences between the conditions or babywearing hours for avoidant or resistant attachment types. The results suggest that infant carrying may be an effective tool at promoting secure attachments, particularly for mothers and infants at greater risk for attachment insecurity.

Infants of adolescent mothers: the Brazilian experience.

In a Brazilian study of 14304 births to adolescent mothers 15-19 years old (98.5%) and those younger than 15 (1.5%) infants were classified according to birth weight: adequate (greater than 3 kg); inadequate (less than or equal to 3 kg); insufficient (2.5-3 kg); and low (less than 2.5 kg). Negative results for low birth weight babies were observed in all neonates less than or equal to 3 kg regardless of maternal age. Average birth weight which was distributed according to socioeconomic level was higher at higher socioeconomic levels. Maternal age was a significant factor for birth weights under 2.5 kg and over 3 kg. Infant weight was higher in direct proportion to higher maternal preconception weight maternal height and maternal weight/height. The same results were found for infant length. Higher birth weight categories were associated with prenatal care. Lower birth weight categories were associated with smoking. In another Brazilian study anthropometry (weight length and head circumference) vitality gestational age and incidence of intrahospital neonate deaths were assessed for infants born from January 1 1991 to December 31 1991 to women of low socioeconomic status attending a Public Maternity Ward in Sao Paulo. 6316 births to 4774 adults (75.6%) and 1542 adolescents (24.4%) were included. 1378 of the adolescents were between 15 and 19 years of age; 164 were under 15. Infant weight distribution (under 2.5 kg and over 3 kg); average infant weight length and head circumference; Apgar scores; and intrahospital neonate deaths were similar in all age groups. Premature births were more prevalent among adolescents.

INFANTS OF ADOLESCENTS AND NEED FOR NEONATAL SPECIAL CARE. † 1593

Infants of adolescent mothers may have increased neonatal complications, but the reasons for this phenomenon are not well understood. We undertook a survey of neonatal morbidity among infants of adolescent mothers at a regional perinatal center. During Oct. `94 - Sept. `95, 8920 live births and 162 infant transports were recorded. 803 (8.8%) of these were born to mothers 2500 g, infants of teen mothers were not more likely to require SCN care than were infants of adult mothers. Severity of illness scores (Score for Neonatal Acute Physiology, SNAP) were calculated for the population of highest risk preterm infants (BW<1500 g), for all SCN-admitted teen births, and for a matched sample of SCN-admitted adult births. No differences were found between teen and adult infant groups for SNAP on day 1 or day 3, nor was there a significant difference in length of stay. We conclude that the increased utilization of neonatal special care services by infants of adolescent mothers is due to the increased risk of low birth weight within the adolescent group. Larger infants of adolescent mothers were neither sicker nor more likely to require SCN care than infants of adult mothers.Table

Risk factors for pertussis in young infants during an outbreak in Chicago in 1993.

Because young infants are at highest risk for severe pertussis and death and are also too young to have received the minimal protective series of three doses of diphtheria-tetanus-pertussis (DTP) vaccine, we conducted a matched case-control study to assess risk factors for pertussis among young infants during a pertussis outbreak in Chicago in 1993. We enrolled 39 cases < 7 months of age from a single teaching hospital and 96 controls, individually matched for age, from the well-child clinic at the same hospital. Demographic characteristics, immunization status, and opportunities for disease exposure were analyzed by means of conditional logistic regression. Cases and controls were similarly up to date with their DTP vaccinations (87% and 89%, respectively). Infants of adolescent mothers (matched odds ratio [OR], 6.4; 95% confidence interval [CI], 1.3-41.4) and infants of mothers who suffered > or = 7 days of cough during the child's incubation period (matched OR, 12.0; 95% CI, 1.4 to infinity) were significantly more likely to have pertussis. Young mothers and mothers with a cough lasting > or = 7 days may be an important source of pertussis infection for their young infants.