Abstract
This study aimed to assess whether maternal age at first marriage is associated with nutritional and developmental penalties in Roma children. Roma nationally representative population-based study. Proxies for child nutritional outcomes included children's individual-level height-for-age z (HAZ) and weight-for-age z (WAZ) scores, HAZ and WAZ scores below two standard deviations from the median of WHO's reference population (children aged 0-59 months), and Early Child Development (children aged 36-59 months). Multiple and logistic regressions were used to estimate the association between maternal age at marriage and the outcomes, and other sociodemographic determinants as possible confounders. Aggregated data from UNICEF's fifth and sixth Multiple Indicator Cluster Surveys for Serbian Roma settlements. Children (n= 2652) aged 0-59 months born to ever-married women aged 15-48. 64% of women married before age 18, 19% of children were stunted, 9% wasted, and Early Child Development score was low. Maternal age at first marriage was not associated with either nutritional status or early development of Roma children. Weight at birth (children aged 0-24) emerged as the main predictor of children's nutritional status. Boys were more likely to be shorter, more stunted and wasted than girls. Child's age, maternal parity and unimproved toilet facility negatively impacted nutritional status, while maternal literacy mitigated against poor nutritional and developmental outcomes. Roma children up to 5 years of age bear no negative consequences of maternal early marriage. The underlying determinants of children's wellbeing include improved sanitation, child characteristics, maternal literacy and reproductive behavior, and parental investment.
Highlights
Individual-level height-for-age Z scores For children aged 0–24 months, age and gender were both negatively associated with height (β = -0·60; 95 % CI (−0·97, −0·24); P < 0·01; and β = -0·17; 95 % CI (−0·26, −0·08); P < 0·01, respectively), while there was a positive association with weight at birth (β = 0·38; 95 % CI (0·28, 0·47); P < 0·01)
For children aged 36–59 months in the adjusted, full model, there was a positive association of maternal literacy (β = 0·10; 95 % CI (0·02, 0·18); P = 0·01) and the type of toilet facility (β = 0·12; 95 % CI (0·05, 0·19); P < 0·01) with weight: children with literate mothers were heavier for 0·10 SD than their counterparts, while children living in households with access to improved toilet facility were heavier for 0·12 SD than children using unimproved toilet
This study tested for possible associations between maternal age at first marriage, child nutritional status and early development among the Serbian Roma
Summary
Study sample The present study was performed as a secondary data analysis of the MICS 5 and 6 for Serbian Roma settlements, a public use data sets, as conducted in Serbia in 2014 and 2019 and carried out by UNICEF (available at http://mics. unicef.org/surveys). Other maternal variables included age at first reproduction, parity, whether a mother ever had a child who later died (as a proxy for child mortality), current marriage status and parental stimulating caregiving practices (as a proxy for parental investment)(30).
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