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

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 clusterrandomized trial (2012)(2013)(2014)(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.

Determinants of coexisting forms of undernutrition among under‐five children: Evidence from the Bangladesh demographic and health surveys

“…A previous study exhibits a similar relationship between the coexistence of underweight with wasting and stunting and the education of mothers (Khaliq, Wraith, Miller, & Nambiar, 2022 ). This study has shown that the marital age of the mother is significantly associated with child malnutrition which is also corroborated by a survey conducted in rural areas of Nepal (Wells et al, 2022 ). The prevalence of malnutrition among children in the Sylhet division is higher than in any other region of Bangladesh.…”

Maternal Age Correlates with Stunting in Children: Systematics Review

“…Maternal factors related to the incidence of stunting include maternal age. Mothers who marry, become pregnant and give birth at a young age may give impacts on the growth of children (Wells et al, 2022). A study conducted in 18 countries in Asia, Africa, and Latin America reveals that in 3 out of 7 countries in Asia and 6 out of 9 countries in Africa there is an effect of mothers who become pregnant and give birth at a young age toward height restriction of children aged 0-11 month.…”

Pemeriksaan Kesehatan Dan Edukasi Kebutuhan Gizi Anak Dan Pencegahan Stunting

“…Di Asia Selatan dan Afrika Timur, pernikahan dini pada perempuan telah diidentifikasi sebagai faktor risiko yang kuat untuk stunting di antara anakanak dalam rentang usia lahir hingga 5 tahun (Efevbera et al, 2017;Khan et al, 2019;Paul et al, 2019). Pernikahan dini dan kehamilan secara langsung berdampak pada pertumbuhan dan status gizi anak, terutama anak sulung (Wells et al, 2022). Hal tersebut mengakibatkan pertumbuhan yang lebih buruk, terutama pada hasil z skor untuk berat badan dan panjang badan, sebab pernikahan dini dan kehamilan dapat meningkatkan berbagai faktor sosial dan biologis yang menyebabkan kekurangan gizi pada anak (Wells et al, 2022).…”

“…Pernikahan dini dan kehamilan secara langsung berdampak pada pertumbuhan dan status gizi anak, terutama anak sulung (Wells et al, 2022). Hal tersebut mengakibatkan pertumbuhan yang lebih buruk, terutama pada hasil z skor untuk berat badan dan panjang badan, sebab pernikahan dini dan kehamilan dapat meningkatkan berbagai faktor sosial dan biologis yang menyebabkan kekurangan gizi pada anak (Wells et al, 2022). Faktor lainnya yang dapat memengaruhi masalah gizi seperti gizi kurang dan stunting yaitu status sosial-ekonomi rumah tangga yang rendah, status antenatal care ibu, berat badan lahir, dan pendidikan ibu (Yuliana & Hakim, 2019) (Beal et al, 2018).…”