Infants born to teenagers are dying at significantly lower rates than they did in the mid-1990s, a new study found. However, researchers did not see these improvements among Black and Hispanic teens in rural areas.
“Inequitable access to health care in rural counties may be driving the racial/ethnic disparities in the lack of improvement over time,” authors wrote in “Disparities in Mortality Trends for Infants of Teenagers: 1996-2019” (Woodall AM, et al. Pediatrics. April 10, 2023).
Authors from the Centers for Disease Control and Prevention (CDC) and University of California, San Francisco School of Medicine analyzed data on infants born to White, Black and Hispanic teens ages 15-19 years. They compared infant mortality rates in 1996-’97 to those 2018-’19. Infant mortality rates for this age group are higher than for older parents.
Data show there was a 64% decrease in infants born to 15- through 19-year-olds over the 24-year study period, which authors attributed to increased sex education and contraceptive use as well as teens waiting longer to have sex.
Among teens who did have babies, there was a nearly 17% drop in infant deaths. The mortality rate per 1,000 live births fell from 10.3 to 8.6, according to the study. Authors said changes in maternal age did not play a significant role.
All three racial groups in large cities, suburbs and smaller towns saw declines in infant mortality. In rural areas, however, mortality declined only for infants born to White teens. The mortality rates for infants of Black and Hispanic teens in rural areas remained about the same.
Hospital-based obstetric services are available in less than half of rural counties, and access issues appear to be affecting racial and ethnic groups in different ways, authors wrote.
Although infant mortality rates for Hispanic teens did not improve in rural areas, this racial group had the lowest infant mortality rate overall. Mortality rates were highest for infants born to Black teens. In 2018-’19, about 12 of every 1,000 infants born to Black teens died, compared to eight infants born to White teens and six infants born to Hispanic teens.
Black mothers of any age have higher preterm birth rates than other races, which research has linked to discrimination that results in higher stress levels and substandard prenatal care, according to the study.
“Results shown here suggest that the racial and ethnic disparity in infant mortality endured over the 24-year study period despite declining teen birth and infant mortality rates, which further suggests that the contextual factors driving the disparity have not improved,” authors wrote.
They highlighted the need for more research on these social and structural factors. Authors of a related commentary also stressed the importance of going beyond the numbers and hearing from the teens experiencing disparities. In addition, they called for community-level efforts.
“These interventions are particularly important in the context of the growing problem of obstetric deserts in rural communities,” they wrote.
Resources
- AAP clinical report Care of Adolescent Parents and Their Children
- AAP policy Emergency Contraception
- AAP policy Barrier Protection Use by Adolescents During Sexual Activity
- AAP clinical report Long-Acting Reversible Contraception: Specific Issues for Adolescents
- AAP policy Options Counseling for the Pregnant Adolescent Patient
- AAP policy The Adolescent’s Right to Confidential Care When Considering Abortion
- Information from the CDC on infant mortality
- Information for parents from HealthyChildren.org on contraception options for teens
