Associations of maternal age at marriage and pregnancy with infant undernutrition: Evidence from first‐time mothers in rural lowland Nepal
Authors
Cortina‐Borja, Mario
Manandhar, Dharma S
Saville, Naomi M
Publication Date
2022-05-24Journal Title
American Journal of Biological Anthropology
ISSN
2692-7691
Publisher
Wiley
Language
en
Type
Article
This Version
AO
VoR
Metadata
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Wells, J. C., Marphatia, A. A., Cortina‐Borja, M., Manandhar, D. S., Reid, A., & Saville, N. M. (2022). Associations of maternal age at marriage and pregnancy with infant undernutrition: Evidence from first‐time mothers in rural lowland Nepal. American Journal of Biological Anthropology https://doi.org/10.1002/ajpa.24560
Description
Funder: National Institute for Health Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre
Abstract
Abstract: Objectives: Maternal 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. Methods: We analyzed data on first‐time mothers (n = 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. Results: For 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. Conclusions: Early 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.
Keywords
RESEARCH ARTICLE, RESEARCH ARTICLES, adolescent pregnancy, child marriage, infant and child undernutrition, rural lowland Nepal, stunting
Sponsorship
Department for International Development (DFID) South Asian Research Hub (PO 5675)
Leverhulme Trust (RPG‐2017‐264)
Identifiers
ajpa24560
External DOI: https://doi.org/10.1002/ajpa.24560
This record's URL: https://www.repository.cam.ac.uk/handle/1810/337434
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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