Abstract: Introduction: Contributing to the Sustainable Development Goals, Global Goals, Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030, we clarify the interaction between maternal age, parity and birth intervals to examine the effects on child health.

Methods: We use Demographic and Health Survey data from 33 sub-Saharan African countries, and apply multivariate Poisson and logistic models to first examine the effect of maternal age (15-17, 18-19, 20-24, 25-29, 30-39) on infant mortality and stunting, then modify this relationship by parity and account for the confounding effects of short birth intervals.

Results: We find that poor infant mortality outcomes of children born to teen mothers are driven by higher parity children, not first-born children. While first-born children of teen mothers are at a high risk of stunting, they are likely to survive. Short birth intervals have a negative effect on infant survival and stunting outcomes. But controlling for short birth intervals does not completely offset the effect of young age at birth on child survival outcomes.

Discussion: High parity children of young mothers are at a high risk of infant mortality, driven in part – but not completely – by short birth intervals. Policies aimed at delaying first birth are warranted, but should not overshadow the need to support adolescent mothers at risk of multiple births that are tightly spaced.

Keywords: Maternal age, parity, birth intervals, child health, sub-Saharan Africa.

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