Burden of neonatal and infant mortality in relation to mother’s age at birth: a regional analysis based in Odisha

Infant Mortality Rate (IMR) and Neonatal Mortality Rate (NMR) remain major public health concerns, particularly among children born to underage mothers. The present study examine the spatial variations in IMR and NMR across districts and identify the socio-demographic and economic determinants associated with higher mortality among children born to underage mothers. This study uses data from various round of Sample registration system and the National Family Health Survey-5 (2019–21). The sample includes 8,522 children born in the five years preceding the survey. Bivariate and multivariate analyses were conducted to evaluate the association between IMR/NMR and maternal age groups (< 18, 18–21, 22–30 years). Spatial analysis using bivariate LISA maps was applied to identify high-risk districts and spatial clustering patterns. The findings indicate that children born to mothers under 18 years face significantly higher IMR and NMR compared to those born to older mothers. Districts like Koraput, Kalahandi, and Nabarangpur showed high-high clustering of early maternal age and infant deaths. Socioeconomic indicators such as education level, birth order, wealth index, and rural residence were also strongly associated with infant outcomes. Maternal age at childbirth is a critical determinant of infant survival. Delaying age at first birth, improving female education, ensuring access to quality maternal health services, and addressing regional disparities are essential to reducing infant and neonatal mortality.