Young Mom, Short Kid: Examining Social, Biological and Health and Nutrition Service Factors Linking Adolescent Pregnancy to Early Childhood Undernutrition in India (P10-011-19)

Abstract

ObjectivesAdolescent pregnancy is a global public health concern and one in five adolescents live in India, where early marriage is widely practiced. We sought to examine linkages between adolescent pregnancy and child undernutrition using a holistic approach. MethodsData were from India’s 2015–2016 National Family Health Surveys. Primiparous women aged 15–49 years who gave birth between 2010 and 2015 (n = 60,096) were classified based on age at first birth: ≤19 years (adolescence), 20–24 years (young adulthood), and ≥25 years (adulthood). Multivariable regression and structural equation models were used to understand how adolescent pregnancy is linked to child undernutrition through women’s education and bargaining power, nutritional status, health service use, child feeding and living conditions. ResultsOverall, 24% of first births among Indian women aged 15–49 years in 2016 occurred during adolescence, with large state and district variability (from 4% to 45% for states and 1% to 62% for districts). Compared to children born to adult mothers, those born to adolescent mothers had lower z-scores for height-for-age (mean difference: -0.53 SD), weight-for-age (-0.40 SD), and weight-for-height (-0.16 SD). Compared to adult mothers, adolescent mothers were shorter (-1.2 cm), more likely to be underweight (+ 18%) and anemic (+ 8%), had lower education (-3.0 years), less bargaining power (-7% to -15%), and lived in poorer households (-0.66 SD) with poorer sanitation (-28%). Adolescent mothers were less likely to access health services (-4% to -15%) and had poorer complementary feeding practices (-3% to -9%). These intermediate factors were predictive of child anthropometry, with the strongest links being women’s education, socioeconomic status, and weight. ConclusionsAdolescent pregnancy is related to maternal nutritional status, education, access to nutrition and health services, complementary feeding practices, and living conditions; together, these are associated with child undernutrition. Policies and programs to delay marriage are likely to help break the intergenerational cycle of poverty and undernutrition in India. Funding SourcesBill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute.