The effect of maternal child marriage on morbidity and mortality of children under 5 in India: Cross sectional study of a nationally representative sample (HTML)
Raj,Anita; Saggurti,Niranjan; Winter,Michael; Labonte,Alan; Decker,Michele R.; Balaiah,Donta; Silverman,Jay G.
British Medical Journal 340 353-
Publication date: 2010
To assess associations between maternal child marriage(marriage before age 18) and morbidity and mortality of infantsand children under 5 in India.
Cross-sectional analyses of nationally representativehousehold sample. Generalised estimating equation models constructedto assess associations. Adjusted models included maternal andchild demographics and maternal body mass index as covariates.
Women aged 15-49 years (n=124 385); data collectedin 2005-6 through National Family Health Survey-3. Data aboutchild morbidity and mortality reported by participants. Analysesrestricted to births in past five years reported by ever marriedwomen aged 15-24 years (n=19 302 births to 13 396 mothers).
Main outcome measures
In under 5s: mortality related infectiousdiseases in the past two weeks (acute respiratory infection,diarrhoea); malnutrition (stunting, wasting, underweight); infant(age <1 year) and child (1-5 years) mortality; low birthweight (<2500 kg).
The majority of births (73%; 13 042/19 302) were tomothers married as minors. Although bivariate analyses showedsignificant associations between maternal child marriage andinfant and child diarrhoea, malnutrition (stunted, wasted, underweight),low birth weight, and mortality, only stunting (adjusted oddsratio 1.22, 95% CI 1.12 to 1.33) and underweight (1.24, 1.14to 1.36) remained significant in adjusted analyses. We notedno effect of maternal child marriage on health of boys versusgirls.
The risk of malnutrition is higher in young childrenborn to mothers married as minors than in those born to womenmarried at a majority age. Further research should examine howearly marriage affects food distribution and access for childrenin India.