Newborn Health Indicators Associated with Maternal Age during First Pregnancy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection
2.2. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Ní Bhrolcháin, M.; Beaujouan, E. Fertility postponement is largely due to rising educational enrolment. Popul. Stud. 2012, 66, 311–327. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Alamillos Guardiola, M.C. La maternidad tardia: Expresión contemporánea del patriarcado occidental. Rev. Antropol. Exp. 2016, 16, 213–221. [Google Scholar] [CrossRef]
- Heras Pérez, B.; Gobernado Tejedor, J.; Mora Cepeda, P.; Almaraz Gómez, A. La edad materna como factor de riesgo obstétrico. Resultados perinatales en gestantes de edad avanzada. Prog. Obs. Ginecol. 2011, 54, 575–580. [Google Scholar] [CrossRef]
- Molina García, L.; Hidalgo Ruiz, M.; Arredondo López, B.; Colomino Ceprián, S.; Delgado Rodríguez, M.; Martínez Galiano, J.M. Maternal Age and Pregnancy, Childbirth and the Puerperium: Obstetric Results. J. Clin. Med. 2019, 8, 672. [Google Scholar] [CrossRef] [PubMed]
- Sydsjö, G.; Pettersson, M.L.; Bladh, M.; Svanberg, A.S.; Lampic, C.; Nedstrand, E. Evaluation of risk factors’ importance on adverse pregnancy and neonatal outcomes in women aged 40 years or older. BMC Pregnancy Childbirth 2019, 19, 92. [Google Scholar] [CrossRef] [PubMed]
- Traisrisilp, K.; Tongsong, T. Pregnancy outcomes of mothers with very advanced maternal age (40 years or more). J. Med. Assoc. Thail. 2015, 98, 117–122. [Google Scholar]
- Kahveci, B.; Melekoglu, R.; Evruke, I.C.; Cetin, C. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy Childbirth 2018, 18, 343. [Google Scholar] [CrossRef] [PubMed]
- Phadungkiatwattana, P.; Rujivejpongsathron, J.; Tunsatit, T.; Yanase, Y. Analyzing pregnancy outcomes in women of extremely advanced maternal age (> or = 45 years). J. Med. Assoc. Thail. 2014, 97, 1–6. [Google Scholar]
- Liu, X.; Zhang, W. Effect of maternal age on pregnancy: A retrospective cohort study. Chin. Med. J. 2014, 127, 2241–2246. [Google Scholar]
- Favilli, A.; Pericoli, S.; Acanfora, M.M.; Bini, V.; Di Renzo, G.C.; Gerli, S. Pregnancy outcome in women aged 40 years or more. J. Matern. Fetal Neonatal Med. 2012, 25, 1260–1263. [Google Scholar] [CrossRef] [PubMed]
- Moya Toneut, C.; Garaboto García, M.E.; Moré Vega, A.; Borges Fernández, R.; Moya Arechavaleta, N.; Moya Arechavaleta, A. Resultados maternos y perinatales en gestantes con avanzada edad materna. Rev. Cuba. Obstet. Ginecol. 2017, 43, 1–13. [Google Scholar]
- González, I.A.; Huespe, M.S.; Auchter, M.C. Lactancia materna exclusiva factores de éxito y/o fracaso. Rev. Posgrado VIa Cátedra Med. 2008, 177, 1–5. [Google Scholar]
- Goisis, A.; Schneider, C.D.; Myrskylä, M. The reversing association between advanced maternal age and child cognitive ability: Evidence from three UK birth cohorts. Int. J. Epidemiol. 2017, 46, 850–859. [Google Scholar] [CrossRef]
- Esteve, A.; Devolder, D.; Domingo, A. La infecundidad en España: Tic-tac, tic-tac, tic-tac!!! Available online: https://ced.uab.cat/wp-content/uploads/2015/12/Boletin-Demogra_CAS_8.pdf (accessed on 4 February 2019).
- Karim, R.; Dang, H.; Henderson, V.W.; Hodis, H.N.; John, J.; Brinton, R.D.; Mack, W.J. Effect of Reproductive History and Exogenous Hormone Use on Cognitive Function in Mid-and Late Life. J. Am. Geriatr. Soc. 2016, 64, 2448–2456. [Google Scholar] [CrossRef] [PubMed]
- Tavares, A.I. Women’s life span and age at parity. J. Public Health 2017, 25, 351–356. [Google Scholar] [CrossRef]
- Brasil Esteves, T.M.; Paiva Daumas, R.; Couto de Oliveora, M.I.; Ferreira de Andrade, C.A.; Costa Leite, L. Factores asociados a la lactancia en la primera hora de vida: Revisión sistemática. Rev. Saúde Públ. 2014, 48, 697–708. [Google Scholar]
- Rios Mori, C.M.; Lias Cuervo, M.P. Contacto piel a piel inmediato al nacimiento y beneficios en el recién nacido sano en los primeros 30 minutos. Cuid. Y Salud 2015, 2, 177–186. [Google Scholar]
- Guzmán Vela, F.P. Calidad Del Contacto Precoz Piel a Piel Entre la Madre y su Recién Nacido a Término Vigoroso Atendidos en el Instituto Nacional Materno Perinatal en el mes de mayo del año 2015. Ph.D. Thesis, Universidad Nacional Mayor de San Marcos, Lima-Perú, Peru, 2015. [Google Scholar]
- Moore, E.R.; Bergman, N.; Anderson, G.C.; Medley, N. Early skin-to-Skin contact for mothers and their healthy newborn infants. Cochrane Database Syst. Rev. 2016, 11. [Google Scholar] [CrossRef]
- Mite Cárdenas, G.V.; Pardo Torres, M.O. Vínculo Afectivo Madres-Hijos Neonatos a Término según Edad y Paridad: Una Comparación. Investig. Res. Rev. 2019, 12, 67–78. [Google Scholar] [CrossRef]
- Giraldo Montoya, D.I.; Castañeda Palacio, H.L.; Mazo Álvarez, H.M. Factores demográficos relacionados con el apego materno infantil. Univ. Y Salud. 2017, 19, 197–206. [Google Scholar] [CrossRef]
- Estrada Rodríguez, J.; Amargós Ramírez, J.; Reyes Domínguez, B.; Guevara Basulto, A. Intervención Educativa Sobre Lactancia Materna. Available online: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552010000200009&lng=es&nrm=iso (accessed on 4 April 2019).
- Oliver Roig, A.; Richart Martínez, M.; Cabrero García, J.; Pérez Hoyos, S.; Laguna Navidad, G.; Flores Álvarez, J.C.; Calatayud Pujalte, M.M.; García de León, R. Factores asociados al abandono de la lactancia materna durante los primeros 6 meses de vida. Rev. Latinoam. Enferm. 2010, 18, 79–87. [Google Scholar]
- Schanler, R.J.; Potak, D.C. Breastfeeding: Parental Education and Support. Available online: http://bit.ly/2aA8gTT (accessed on 25 March 2019).
- Ministry of Health and Social Policy. Clinical Practice Guidelines on Normal Childbirth Care, 1st ed.; Servicio Central de Publicaciones del Gobierno Vasco: Vitoria, Spain, 2010. [Google Scholar]
- Alvarez Caballero, M.; Orozco Hechavarría, N.; Moreno Alvarez, A.; Marín Álvarez, T.; Tur Vaillant, I. Factores que influyeron en el abandono precoz de la lactancia materna en lactantes de un Grupo Básico de Trabajo. Rev. Méd. Electrón. 2017, 39, 884–893. [Google Scholar]
- Asociación Española de Pediatría. Test de Apgar. Available online: https://www.aeped.es/rss/en-familia/test-apgar (accessed on 20 May 2019).
- Laffita Batista, A. Factores que influyen en el apgar bajo al nacer, en el hospital América Arias de La Habana. Cuba. Rev. Chil. Obstet. Ginecol. 2000, 70, 359–363. [Google Scholar]
- Machado, C.J.; Hill, K. Maternal, neonatal and community factors influencing neonatal mortality in Brazil. J. Biosoc. Sci. 2005, 37, 193–208. [Google Scholar] [CrossRef] [PubMed]
- Rodríguez Núñez, A.; Balestena Sánchez, J.M.; Pagarizabal Millán, E. Factores Maternos Que Influyen en la Depresión Neonatal. Available online: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2003000100002&lng=es&nrm=is (accessed on 4 April 2019).
- Goisis, A.; Remes, H.; Barclay, K.; Martikainen, P.; Myrskylä, M. Advanced maternal age and the risk of low birth weight and preterm delivery: A within-Family analysis using Finnish population registers. Am. J. Epidemiol. 2017, 186, 1219–1226. [Google Scholar] [CrossRef]
- Wu, Y.; Chen, Y.; Shen, M.; Guo, Y.; Wen, S.; Lanes, A.; Hua, X. Adverse maternal and neonatal outcomes among singleton pregnancies in women of very advanced maternal age: A retrospective cohort study. BMC Pregnancy Childbirth 2019, 19, 3. [Google Scholar] [CrossRef]
- Ratnasiri Anura, W.G.; Parry Steven, S.; Arief Vivi, N.; DeLacy Ian, H.; Halliday Laura, A.; DiLibero Ralph, J.; Basford Kaye, E. Recent trends, risk factors, and disparities in low birth weight in California, 2005–2014: A retrospective study. Matern. Health Neonatol. Perinatol. 2018, 4, 15. [Google Scholar] [CrossRef]
- Hidalgo-Lopezosa, P.; Jiménez-Ruz, A.; Carmona-Torres, J.M.; Hidalgo-Maestre, M.; Rodríguez-Borrego, M.A.; López-Soto, P.J. Sociodemographic factors associated with preterm birth and low birth weight: A cross-Sectional study. Women Birth 2019. [Google Scholar] [CrossRef]
- Acharya, D.; Singh, J.K.; Kadel, R.; Yoo, S.J.; Park, J.H.; Lee, K. Maternal Factors and Utilization of the Antenatal Care Services during Pregnancy Associated with Low Birth Weight in Rural Nepal: Analyses of the Antenatal Care and Birth Weight Records of the MATRI-SUMAN Trial. Int. J. Environ. Res. Public Health 2018, 15, 2450. [Google Scholar] [CrossRef]
Variable | Value |
---|---|
Mean age (SD) | 30.45 (5.63) |
Civil status, n (%) | |
Single | 102 (27.3) |
Married | 232 (62.2) |
De facto relationship | 36 (9.7) |
Divorced | 3 (0.8) |
Nationality, n (%) | |
Spanish | 366 (98.1) |
Other | 7 (1.9) |
Education level, n (%) | |
None | 8 (2.1) |
Primary | 25 (6.7) |
Secondary | 105 (28.2) |
Baccalaureate/Professional formation | 94 (25.2) |
University | 141 (37.8) |
Income level, n (%) | |
<1000 Euros | 98 (29.3) |
1000–1999 Euros | 137 (41.0) |
2000–2999 Euros | 68 (20.4) |
≥3000 Euros | 31 (9.3) |
Employed during pregnancy, n (%) | |
No | 108 (29.0) |
Yes | 265 (71.0) |
Presence of illness, n (%) | |
No | 326 (87.6) |
Yes | 46 (12.4) |
Previous miscarriages, n (%) | |
No | 280 (75.1) |
Yes | 93 (24.9) |
Planned pregnancy, n (%) | |
No | 47 (12.6) |
Yes | 326 (87.4) |
Antenatal classes, n (%) | |
No | 155 (41.6) |
Yes | 218 (58.4) |
Pregnancy care, n (%) | |
Public health system | 182 (48.8) |
Private | 7 (1.9) |
Both | 184 (49.3) |
Medical assistance to achieve pregnancy, n (%) | |
No | 327 (87.7) |
Yes | 46 (12.3) |
Gestational week of birth, mean (SD) | 39.43 (1.41) |
Infant weight (g), mean (SD) | 3255.27 (434.21) |
Newborn head circumference (cm), mean (SD) | 30.46 (2.47) |
Newborn length (cm), mean (SD) | 49.46 (2.80) |
Apgar score at 1 min, mean (SD) | 8.84 (0.53) |
Apgar score at 5 min, mean (SD) | 9.44 (0.53) |
Variable | Total, n | Crude Analysis | Multivariate Analysis * | ||
---|---|---|---|---|---|
Age of Mother m ± SEM | p Value | Age of Mother m ± SEM | p Value | ||
Skin-to-skin | <0.001 | 0.042 | |||
No | 75 | 32.48 ± 0.58 | 31.49 ± 0.66 | ||
Yes | 298 | 29.94 ± 0.33 | 29.95 ± 0.31 | ||
Early initiation of breastfeeding | 0.004 | 0.164 | |||
No | 59 | 32.35 ± 0.76 | 31.23 ± 0.73 | ||
Yes | 305 | 30.08 ± 0.31 | 30.12 ± 0.30 | ||
Small for gestational age | 0.624 | 0.866 | |||
No | 331 | 30.48 ± 0.31 | 30.25 ± 0.28 | ||
Yes | 40 | 30.02 ± 0.77 | 30.11 ± 0.82 | ||
Low birth weight (<2500 g) | 0.901 | 0.488 | |||
No | 353 | 30.46 ± 0.30 | 30.31 ± 0.28 | ||
Yes | 20 | 30.30 ± 1.32 | 29.43 ± 1.23 | ||
Preterm infant | 0.253 | 0.324 | |||
No | 361 | 30.39 ± 0.30 | 30.22 ± 0.27 | ||
Yes | 12 | 32.29 ± 1.76 | 31.78 ± 1.56 | ||
Newborn health problems identified in the hospital | 0.898 | 0.738 | |||
No | 357 | 30.45 ± 0.29 | 30.24 ± 0.28 | ||
Yes | 16 | 30.63 ± 1.87 | 30.68 ± 1.27 | ||
Complications in the newborn during the hospital stay | 0.491 | 0.174 | |||
No | 334 | 30.39 ± 0.31 | 30.14 ± 0.28 | ||
Yes | 39 | 31.04 ± 0.98 | 31.35 ± 0.84 | ||
Hospital admission of the newborn | 0.195 | 0.082 | |||
No | 351 | 30.36 ± 0.30 | 30.14 ± 0.28 | ||
Yes | 22 | 31.97 ± 1.34 | 32.12 ± 1.10 | ||
Exclusive breastfeeding during the first two months | 0.441 | 0.831 | |||
No | 196 | 30.24 ± 0.45 | 30.21 ± 0.38 | ||
Yes | 177 | 30.69 ± 0.36 | 30.33 ± 0.40 | ||
Infant health problems during the first two months of life | 0.064 | 0.154 | |||
No | 350 | 30.32 ± 0.30 | 30.16 ± 0.28 | ||
Yes | 23 | 32.56 ± 1.39 | 31.76 ± 1.08 | ||
Reason for abandonment of exclusive breastfeeding | 0.557 | ||||
Did not abandon breastfeeding | 187 | 30.75 ± 0.36 | 30.33 ± 0.39 | ref. | |
Medical prescription | 3 | 31.87 ± 1.80 | 30.96 ± 2.86 | 0.828 | |
No milk | 58 | 29.53 ± 0.88 | 30.58 ± 0.69 | 0.752 | |
Infant remained hungry | 85 | 30.96 ± 0.68 | 30.39 ± 0.57 | 0.926 | |
Did not want to continue breastfeeding | 8 | 28.94 ± 1.74 | 28.31 ± 1.89 | 0.297 | |
Had to return to work | 3 | 30.21 ± 1.47 | 28.57 ± 2.88 | 0.546 | |
Other | 29 | 29.22 ± 1.19 | 29.37± 1.00 | 0.378 | |
Type of infant feeding during hospital stay | 0.598 | ||||
Exclusively breastfed | 214 | 30.47 ± 0.36 | 30.27 ± 0.36 | ref. | |
Mixed | 119 | 30.62 ± 0.57 | 30.10 ± 0.48 | 0.783 | |
Formula | 39 | 29.59 ± 0.88 | 30.41 ± 0.84 | 0.884 |
Variable | Age of Mother (Years) | |||
---|---|---|---|---|
<25 n (%) | 25–29 n (%) | 30–34 n (%) | ≥35 n (%) | |
Skin-to-skin No Yes | 3 (5.88) 48 (94.12) | 16 (18.18) 72 (81.82) | 25 (18.66) 109 (81.34) | 31 (31.00) 69 (69.00) |
OR, 95%CI p value | 1 ref. | 0.28 (0.08–1.02) 0.053 | 0.27 (0.08–0.95) 0.041 | 0.14 (0.04–0.48) 0.002 |
ORa *, 95%CI p value | 1 ref. | 0.27 (0.07–1.12) 0.072 | 0.29 (0.07–1.20) 0.088 | 0.17 (0.04–0.71) 0.015 |
Early initiation of breastfeeding No Yes | 5 (10.20) 44 (89.80) | 10 (11.63) 76 (88.37) | 21 (15.67) 113 (84.33) | 23 (24.21) 72 (75.79) |
OR, 95%CI p value | 1 ref. | 0.86 (0.28–2.69) 0.800 | 0.61 (0.22–1.72) 0.352 | 0.36 (0.13–1.00) 0.051 |
ORa *, 95%CI p value | 1 ref. | 1.03 (0.27–3.91) 0.960 | 0.78 (0.22–2.80) 0.700 | 0.55 (0.15–2.06) 0.374 |
Small for gestational age No Yes | 46 (90.20) 5 (9.80) | 77 (88.51) 10 (11.49) | 118 (88.06) 16 (11.94) | 90 (90.91) 9 (9.09) |
OR, 95%CI p value | 1 ref. | 1.19 (0.38–3.71) 0.758 | 1.25 (0.43–3.60) 0.683 | 0.92 (0.29–2.90) 0.887 |
ORa *, 95%CI p value | 1 ref. | 1.44 (0.40–5.19) 0.577 | 1.47 (0.41–5.20) 0.552 | 1.26 (0.32–5.00) 0.745 |
Low birth weight (<2500 g) No Yes | 49 (96.08) 2 (3.92) | 82 (93.18) 6 (6.82) | 127 (94.78) 7 (5.22) | 95 (95.00) 5 (5.00) |
OR, 95%CI p value | 1 ref. | 1.79 (0.35–9.23) 0.485 | 1.35 (0.27–6.73) 0.714 | 1.29 (0.24–6.89) 0.766 |
ORa *, 95%CI p value | 1 ref. | 1.33 (0.23–7.64) 0.751 | 0.83 (0.13–5.18) 0.846 | 0.86 (0.12–6.06) 0.877 |
Preterm infant No Yes | 50 (98.04) 1 (1.96) | 86 (97.63) 2 (2.27) | 130 (97.01) 4 (2.99) | 95 (95.00) 5 (5.00) |
OR, 95%CI p value | 1 ref. | 1.16 (0.10–13.15) 0.903 | 1.54 (0.17–14.10) 0.703 | 2.63 (0.30–23.14) 0.383 |
ORa *, 95%CI p value | 1 ref. | 1.21 (0.10–14.70) 0.880 | 1.56 (0.13–18.66) 0.725 | 2.63 (0.22–31.41) 0.444 |
Newborn health problems detected in the hospital No Yes | 46 (90.20) 5 (9.80) | 88 (100.00) 0 (0.00) | 130 (97.01) 4 (2.99) | 93 (93.00) 7 (7.00) |
OR, 95%CI p value | 1 ref. | 1 (omitted) | 0.28 (0.07–1.10) 0.068 | 0.69 (0.21–2.30) 0.549 |
ORa *, 95%CI p value | 1 ref. | 1 (omitted) | 0.26 (0.05–1.24) 0.090 | 0.66 (0.13–3.31) 0.611 |
Newborn complications during the hospital stay No Yes | 45 (88.24) 6 (11.76) | 82 (93.18) 6 (6.82) | 118 (88.06) 16 (11.94) | 89 (89.00) 11 (11.00) |
OR, 95%CI p value | 1 ref. | 0.55 (0.17–1.80) 0.322 | 1.02 (0.37–2.76) 0.974 | 0.93 (0.32–2.67) 0.888 |
ORa *, 95%CI p value | 1 ref. | 0.95 (0.25–3.69) 0.942 | 1.56 (0.44–5.49) 0.493 | 1.64 (0.42–6.38) 0.478 |
Newborn hospital admission No Yes | 48 (94.12) 3 (5.88) | 86 (97.73) 2 (2.27) | 126 (94.03) 8 (5.97) | 91 (91.00) 9 (9.00) |
OR, 95%CI p value | 1 ref. | 0.37 (0.06–2.31) 0.288 | 1.02 (0.26–3.99) 0.982 | 1.58 (0.41–6.12) 0.506 |
ORa *, 95%CI p value | 1 ref. | 0.64 (0.08–4.92) 0.671 | 2.00 (0.36–11.11) 0.428 | 2.80 (0.48–16.42) 0.253 |
Exclusive breastfeeding in the first two months of life No Yes | 34 (66.67) 17 (33.33) | 47 (53.41) 41 (46.59) | 56 (41.79) 78 (58.21) | 59 (59.00) 41 (41.00) |
OR, 95%CI p value | 1 ref. | 1.74 (0.85–3.57) 0.128 | 2.79 (1.42–5.48) 0.003 | 1.39 (0.69–2.81) 0.360 |
ORa *, 95%CI p value | 1 ref. | 1.36 (0.62–2.98) 0.435 | 1.94 (0.90–4.20) 0.091 | 1.08 (0.46–2.52) 0.863 |
Infant health problems during the first two months of life No Yes | 47 (92.16) 4 (7.84) | 87 (98.86) 1 (1.14) | 128 (95.52) 6 (4.48) | 88 (88.00) 12 (12.00) |
OR, 95%CI p value | 1 ref. | 0.14 (0.01–1.24) 0.077 | 0.55 (0.15–2.04) 0.372 | 1.60 (0.49–5.24) 0.436 |
ORa *, 95%CI p value | 1 ref. | 0.13 (0.01–1.38) 0.091 | 0.43 (0.09–2.08) 0.297 | 1.15 (0.24–5.46) 0.857 |
Variable | Crude Analysis | Multivariate Analysis * | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Age of Mother (Years) m ± SEM | p Value | Age of Mother (Years) m ± SEM | p Value | |||||||
<25 | 25–29 | 30–34 | ≥35 | <25 | 25–29 | 30–34 | ≥35 | |||
Newborn weight (g) | 3277.45 ± 56.49 | 3303.07 ± 50.62 | 3244.85 ± 39.44 | 3215.85 ± 97.95 | 0.738 | 3287.12 ± 69.07 | 3310.56 ± 48.95 | 3256.70 ± 39.62 | 3223.41 ± 49.42 | 0.776 |
Newborn head circumference (cm) | 34.56 ± 0.28 | 34.61 ± 0.30 | 34.43 ± 0.22 | 34.32 ± 0.22 | 0.910 | 34.25 ± 0.40 | 34.71 ± 0.29 | 34.52 ± 0.23 | 34.39 ± 0.29 | 0.348 |
Newborn length (cm) | 49.13 ± 0.44 | 49.54 ± 0.35 | 49.5 ± 0.22 | 49.52 ± 0.25 | 0.405 | 49.30 ± 0.46 | 49.61 ± 0.32 | 49.48 ± 0.27 | 49.45 ± 0.33 | 0.585 |
Apgar score at 1 min. | 8.94 ± 0.05 | 8.92 ± 0.04 | 8.79 ± 0.05 | 8.79 ± 0.06 | 0.825 | 8.88 ± 0.09 | 8.91 ± 0.06 | 8.81 ± 0.05 | 8.80 ± 0.06 | 0.746 |
Apgar score at 5 min. | 9.53 ± 0.07 | 9.53 ± 0.05 | 9.40 ± 0.05 | 9.35 ± 0.05 | 0.960 | 9.53 ± 0.08 | 9.54 ± 0.06 | 9.40 ± 0.05 | 9.36 ± 0.06 | 0.993 |
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Molina-García, L.; Hidalgo-Ruiz, M.; Cámara-Jurado, A.M.; Fernández-Valero, M.J.; Delgado-Rodríguez, M.; Martínez-Galiano, J.M. Newborn Health Indicators Associated with Maternal Age during First Pregnancy. Int. J. Environ. Res. Public Health 2019, 16, 3448. https://doi.org/10.3390/ijerph16183448
Molina-García L, Hidalgo-Ruiz M, Cámara-Jurado AM, Fernández-Valero MJ, Delgado-Rodríguez M, Martínez-Galiano JM. Newborn Health Indicators Associated with Maternal Age during First Pregnancy. International Journal of Environmental Research and Public Health. 2019; 16(18):3448. https://doi.org/10.3390/ijerph16183448
Chicago/Turabian StyleMolina-García, Leticia, Manuel Hidalgo-Ruiz, Ana María Cámara-Jurado, Maria Jose Fernández-Valero, Miguel Delgado-Rodríguez, and Juan Miguel Martínez-Galiano. 2019. "Newborn Health Indicators Associated with Maternal Age during First Pregnancy" International Journal of Environmental Research and Public Health 16, no. 18: 3448. https://doi.org/10.3390/ijerph16183448