Adolescent Childbirth and Mobility Disability Among Women Ages 15-49: An Analysis of Population Health Surveys from 14 Low- and Middle-Income Countries

Abstract

Background: Adolescent childbirth is associated with older adult adverse health outcomes that negatively affect mobility function, but these associations have not been studied globally in large samples of reproductive-age women. This study examines the association between age at first childbirth and mobility disability in national surveys from low- and middle-income countries. Methods: Population health surveys from 2013-2018 containing mobility disability measures among ever-pregnant women ages 15-49 were analyzed (14 countries). Covariates included current age, urban/rural residence, education, and household wealth. Poisson regression models were used to estimate prevalence ratios (PR) of mobility disability among women who first gave birth during adolescence (19 years or younger) and in adult life (ages 20 to 45 years) in each country and across the whole sample. Countries were also analyzed according to the use of standard and non-standard mobility disability measures. Findings: Prevalence of adolescent childbirth (17·5%-66·2%) and mobility disability (0·32%-21·45%) varied widely across countries. Adolescent childbirth was significantly (p<0·05) associated with greater mobility disability in 6 of 8 countries utilizing standard disability measures. Among the 6 countries that did not use standard disability measures, none showed a statistically significant association between adolescent childbirth and mobility disability. Considering the whole sample and adjusting for all covariates, women who gave birth during adolescence had greater prevalence of mobility disability (Pooled PR 1·19, 95%CI 1·06-1·31). Interpretation: This analysis suggests a moderate and consistent association of adolescent childbearing with subsequent mobility disability. Adolescent childbearing appears to contribute to lasting negative effects on women’s mobility. Funding: Fogarty International Center: 5R21TW010466-02 Declaration of Interest: None to declare. Ethical Approval: Ethical approval statement: For this study, we conducted secondary data analysis of fully de-identified public use data sets. As such, our research does not fall within the regulatory definition of research involving human subjects and does not require ethical approval.