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Associations of maternal age at marriage and pregnancy with infant undernutrition: Evidence from first-time mothers in rural lowland Nepal

Published version
Peer-reviewed

Change log

Authors

Cortina-Borja, M 
Manandhar, DS 
Reid, AM 

Abstract

jats:titleAbstract</jats:title>jats:secjats:titleObjectives</jats:title>jats:pMaternal factors shape the risk of infant undernutrition, however the contributions of age at marriage versus age at pregnancy are rarely disentangled. We explore these issues in a population from lowland rural Nepal, where median ages at marriage and first pregnancy are 15 and 17 years respectively and marriage almost always precedes pregnancy.</jats:p></jats:sec>jats:secjats:titleMethods</jats:title>jats:pWe analyzed data on first‐time mothers (jats:italicn =</jats:italic> 3002) from a cluster‐randomized trial (2012–2015). Exposures were ages at marriage and pregnancy, categorized into groups. Outcomes were z‐scores for weight (WAZ), length (LAZ), head circumference (HCAZ), and weight‐for‐length (WLZ), and prevalence of wasting and stunting, for neonates (<8 days) and infants (6–12 months). Mixed linear and logistic regression models tested associations of marriage and pregnancy ages with outcomes, adjusting for parental education, household assets, caste, landholding, seasonality, child sex, intervention arm, randomization strata and cluster.</jats:p></jats:sec>jats:secjats:titleResults</jats:title>jats:pFor neonates, pregnancy <18 years predicted lower LAZ, and <19 years predicted lower WAZ and HCAZ. Results were largely null for marriage age, however early pregnancy and marriage at 10–13 years independently predicted neonatal stunting. For infants, earlier pregnancy was associated with lower LAZ and HCAZ, with a trend to lower WAZ for marriage 10–13 years. Early pregnancy, but not early marriage, predicted infant stunting.</jats:p></jats:sec>jats:secjats:titleConclusions</jats:title>jats:pEarly marriage and pregnancy were associated with poorer growth, mainly in terms of LAZ and HCAZ. Associations were stronger for neonatal than infant outcomes, suggesting pregnancy is more susceptible to these stresses. Early marriage and pregnancy may index different social and biological factors predicting child undernutrition.</jats:p></jats:sec>

Description

Funder: National Institute for Health Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre

Keywords

4401 Anthropology, 44 Human Society, Infant Mortality, Perinatal Period - Conditions Originating in Perinatal Period, Prevention, Pediatric, Clinical Research, Reproductive health and childbirth, 2 Zero Hunger, 3 Good Health and Well Being

Journal Title

American Journal of Biological Anthropology

Conference Name

Journal ISSN

2692-7691
2692-7691

Volume Title

Publisher

Wiley
Sponsorship
Department for International Development (DFID) South Asian Research Hub (PO 5675)
Leverhulme Trust (RPG‐2017‐264)