Abstract

Researchers agree that early marriage (EM) and adolescent pregnancy (AP) can form severe risks for women’s somatic, mental, and reproductive health, as well as on educational and social status. Yet, less is known about factors that may moderate or mediate these associations. This study examined, first, retrospectively the impacts of EM and AP on self-reported mental and somatic health among multicultural group of women living in Eastern Anatolia, Turkey. Second task was to analyze whether and how the partner violence would mediate and/or moderate between EM and AP and mental health problems. The participants were 1569 women (16–72 years of age), who reported their age of being married, first pregnancy, and demographic characteristics. They described their mental health status through General Health Questionnaire (GHQ-28: depressive, anxiety, social dysfunction, and somatization symptoms) and symptoms of posttraumatic stress disorder (PTSD; DSM-5). Women’s reports of somatic illnesses were classified according to WHO-ICD-10. The revised conflict tactics scale, short form was used as a proxy to partner violence. Women who gave birth at 13–19 years of age reported more anxiety and somatization symptoms than later delivered, and those married younger than 25 showed a higher level of depressive symptoms than later married. Both AP and EM formed a heightened risk for somatic illnesses. The partner violence functioned as a moderator; AP was associated with especially high levels of depressive and anxiety symptoms among women exposed to sexual coercion in their marriage. Non-significant mediation analysis indicates that partner violence did not explain the severe impacts of the AP and EM on women’s mental health. Yet, the AP and EM were associated with heightened level of partner violence. Adolescent pregnancy forms a comprehensive mental health risk, and both AP and EM were risks for somatic illnesses, such as cardiovascular problems. The mental health risk of AP further intensified if women experienced sexual coercion in their partnership. Our fundamental work is to abolish these patriarchal phenomena.

Highlights

  • Adolescent pregnancy (AP) and early marriage (EM) are considered public health and social risks, as well as individual tragedy

  • Crosstabs with χ2 statistics tested whether EM and adolescent pregnancy (AP) were associated with somatic illnesses

  • Our findings confirmed that especially adolescent pregnancy (AP) formed a severe risk for women’s mental health, and both AP and early marriage (EM) for somatic health

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Summary

Introduction

Adolescent pregnancy (AP) and early marriage (EM) are considered public health and social risks, as well as individual tragedy. They are associated with mental health (Buzi et al 2015), parenting (Secco and Moffatt 2003), and educational (Erulkar 2013) problems, as well as with obstetric risks (Azevedo et al 2015). Posttraumatic stress disorder symptoms The nine-item National Stressful Events Survey PTSD Short Scale (NSESSS-PTSD) (LeBeau et al 2014) is based on the DSM-5 diagnostic criteria and covers the dimensions of intrusion, avoidance, and hypervigilance, as well as negative cognitive-affective responses. A student-based study found the Turkish version of the NSESSS-PTSD to be psychometrically sound PTSD screening measure with high convergent and discriminant validity, and reliability as well as good sensitivity and specificity (Evren et al 2016)

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