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dc.contributor.authorMiller, Faith A
dc.contributor.authorMarphatia, Akanksha A
dc.contributor.authorWells, Jonathan C
dc.contributor.authorCortina-Borja, Mario
dc.contributor.authorManandhar, Dharma S
dc.contributor.authorSaville, Naomi M
dc.date.accessioned2021-12-22T15:07:12Z
dc.date.available2021-12-22T15:07:12Z
dc.date.issued2022-05
dc.date.submitted2021-06-29
dc.identifier.issn1042-0533
dc.identifier.otherajhb23709
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/331710
dc.descriptionFunder: National Institute for Health Research; Id: http://dx.doi.org/10.13039/501100000272
dc.description.abstractOBJECTIVES: Preterm delivery (<37 weeks gestation) is the largest cause of child mortality worldwide. Marriage and pregnancy during adolescence have been associated with an increased risk of preterm delivery. We investigate independent associations of age at marriage and age at first pregnancy with preterm delivery in a cohort of women from rural lowland Nepal. METHODS: We analyzed data from 17 974 women in the Low Birth Weight South Asia Trial. Logistic regression models tested associations of age at marriage and age at first pregnancy with preterm delivery, for primigravida (n = 6 243) and multigravida (n = 11 731) women. Models were adjusted for maternal education, maternal caste, and household asset score. RESULTS: Ninety percent of participants had married at <18 years and 58% had their first pregnancy at <18 years. 20% of participants delivered preterm. Primigravida participants married at ≤14 years had higher odds of preterm delivery than those married ≥18 years, when adjusting for study design (adjusted odds ratio (aOR) 1.45, 95% CI: 1.15-1.83), confounders (aOR 1.28: 1.01-1.62) and confounders + age at pregnancy (aOR 1.29: 1.00-1.68). Associations were insignificant for multigravida women. No significant associations were observed between age at first pregnancy and preterm delivery. DISCUSSION: In this population, early marriage, rather than pregnancy, is a risk factor for preterm delivery. We hypothesize that psychological stress, a driver of preterm delivery which is increased among those marrying young, rather than physiological immaturity, drives this association. Further research into the psychological consequences of child marriage in Nepal is needed.
dc.languageen
dc.publisherWiley
dc.subjectORIGINAL ARTICLE
dc.subjectORIGINAL ARTICLES
dc.titleAssociations between early marriage and preterm delivery: Evidence from lowland Nepal.
dc.typeArticle
dc.date.updated2021-12-22T15:07:11Z
prism.publicationNameAm J Hum Biol
dc.identifier.doi10.17863/CAM.79160
dcterms.dateAccepted2021-11-23
rioxxterms.versionofrecord10.1002/ajhb.23709
rioxxterms.versionAO
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidMiller, Faith A [0000-0002-0766-7727]
dc.contributor.orcidWells, Jonathan C [0000-0003-0411-8025]
dc.contributor.orcidSaville, Naomi M [0000-0002-1735-3684]
dc.identifier.eissn1520-6300
pubs.funder-project-idDepartment for International Development (PO 5675)
pubs.funder-project-idLeverhulme Trust (RPG‐2017‐264)
pubs.funder-project-idMedical Research Council (MR/N013867/1)
cam.issuedOnline2021-12-04


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