Prevalence, characteristics, and adverse birth outcomes of teen births in West Virginia: A population-based study.

Study objective: Despite falling teen birth rates in the United States, there is a disproportionate burden of teen births in rural regions. The study aims to investigate the characteristics of teenage mothers and examine the relationships between teen birth and adverse birth outcomes in the rural Appalachian state of West Virginia (WV).

Methods: Data was obtained from a population-based cohort (Project WATCH) of all singleton live births in WV between May 2018 and April 2023. The primary exposure variable was mothers who gave birth when they were less than 20 years old (teenage births v. adult). Primary outcomes included birthweight, gestational age, NICU admission, 5-minute Apgar score, and breastfeeding status.

Results: Of 86,447 live births, 5,310 (6.15%) were birth to teenage mothers. Maternal characteristics of teenage mothers included minority racial groups, lower education, Medicaid, rural residence, and inadequate prenatal care. Teenage births were associated with lower mean birthweight aMD [b = -49.31g. (-65.37, -33.24)], low birthweight [<2500g. vs. ≥2500 g., aRR = 1.11 (1.0, 1.24)], and small for gestational age [v. appropriate for gestational age, aRR = 1.21 (1.12,1.30)]. Teenage mothers were less likely to exclusively breastfeed at discharge [aRR, 1.20 (1.11, 1.28)]. Analyses adjusted for maternal race/ethnicity, education, health insurance, smoking, substance use, prenatal care, diabetes, and residence type.

Conclusions: Teenage births are high in WV and are linked to adverse infant outcomes. These findings may help identify at-risk groups for support and provide policymakers with information to design effective interventions to prevent teenage births and its negative outcomes.