Maternal Age at Marriage and Adverse Pregnancy Outcomes: Findings from the India Human Development Survey, 2011-2012

Abstract

Study objective: This study aimed to examine the association between maternal age at marriage and selected pregnancy outcomes: stillbirth, miscarriage, and complications during pregnancy, labor, and postpartum period.

Design: Cross-sectional study.

Setting: India.

Participants: A total of 35,253 ever-married women aged 15-49 years from the second round of the India Human Development Survey were used to examine the association between maternal age at marriage and stillbirth and miscarriage. Moreover, 14,229 ever-married women who gave birth since January 2005 were used to assess the effect of maternal age at marriage on pregnancy, labor, and postpartum complications.

Interventions: Cross-tabulation, Pearson's χ² test, and binary logistic regression were performed for the analyses of the study data.

Main outcome measures: Stillbirth, miscarriage, and complications during pregnancy, labor, and postpartum period.

Results: Bivariate association showed significant differences in women's pregnancy outcomes according to their age at marriage. Multivariate logistic regression analyses revealed that after controlling for relevant demographic characteristics, the likelihood of stillbirth (adjusted odds ratio [AOR], 1.12; P < .05), miscarriage (AOR, 1.15; P < .01), pregnancy complications (AOR, 1.24; P < .01), and postnatal complications (AOR, 1.32; P < .01) were significantly higher among the women who married at 14 years or younger than those married at the age of 18 years or later. However, the current study did not show any significant association between the women who married at 15-17 years and the pregnancy outcomes except for postnatal complications (AOR, 1.12; P < .05) in adjusted analyses.

Conclusion: This study showed that early maternal age at marriage substantially increases the risk of adverse pregnancy outcomes, which suggests strengthening of existing laws and policies to increase age at marriage of girls, and effort should be made to improve health status of married adolescents.

Keywords: Age at marriage; Labor; Miscarriage; Postpartum period; Pregnancy; Stillbirth.