Maternal and Child Health Journal

, Volume 19, Issue 8, pp 1864–1880 | Cite as

The Effect of Early Marriages and Early Childbearing on Women’s Nutritional Status in India



The consequences of early childbearing on the growth and nutritional status of women in India has not been quantified in previous studies. Our study aimed to fill this gap by analysing the association between early marriage and early childbearing on nutritional status of Indian women, with a focus on Bihar and Andhra Pradesh, the two states accounting for the highest proportion of women marrying and giving first birth before 18 years of age. Our findings revealed that a substantial number of women were married before 18 years and thereby exposed to early pregnancy. Furthermore, a significantly higher proportion of women in the ‘thin’ category were married before 18 years, both in the Indian sample (33 %, p < 0.001) and in the selected states, Andhra Pradesh (31 %, p < 0.001) and Bihar (43 %, p < 0.001), compared to those women married at higher ages. Similarly, across all our samples women whose first birth was before age 18 years also had a significantly higher probability of being in the ‘thin’ category across all our samples. This pattern was also observed for associations between early childbirth and anemia levels. We conclude that the net effect of the early age at marriage and age at first birth on nutritional status is significant. Our results underline the need for preventing early marriages and the consequent high adolescent pregnancies in India, particularly in high prevalence states. This will help to improve nutritional status and health care utilisation among women, thereby, prevent maternal and child mortality and thus, achieve the MDGs 4–5.


Early marriage Early childbearing Nutritional status Women India 

Supplementary material

10995_2015_1700_MOESM1_ESM.docx (380 kb)
Supplementary material 1 (DOCX 380 kb)


  1. 1.
    Blum, R. W., & Mmari-Nelson, K. (2004). The health of young people in a global context. Journal of Adolesent Health, 35(5), 402–418.CrossRefGoogle Scholar
  2. 2.
    Temin, M., & Levine, R. (2009). Start with a girl: A new agenda for global health. Washington: Center for Global Development.Google Scholar
  3. 3.
    Hobcraft, J. N., Mc Donald, J. W., & Rustein, O. S. (1985). Demographic determinants of infant and early child mortality: A comparative analysis. Population Studies, 39(3), 363–385.CrossRefGoogle Scholar
  4. 4.
    National Research Council. (1989). Contraception and reproduction: Health consequences for women and children in the developing world. Washington DC: National Academy Press.Google Scholar
  5. 5.
    Steer, P. J. (2000). Maternal hemoglobin concentration and birth weight. American Journal of Clinical Nutrition, 71, 1285S–1287S.PubMedGoogle Scholar
  6. 6.
    Stoltzfus, R. J., Mullany, L., & Black, R. E. (2004). Iron deficiency anemia. In M. Ezzati, A. D. Lopez, A. Rodgers, & C. J. L. Murray (Eds.), Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors (pp. 163–210). Geneva: World Health Organisation.Google Scholar
  7. 7.
    Kozuki, N., Lee, A. C., & Katz, J. (2012). Moderate to severe, but not mild, maternal anemia is associated with increased risk of small-for-gestational-age outcomes. Journal of Nutrition, 142, 358–362.PubMedCrossRefGoogle Scholar
  8. 8.
    Ransom E. I., & Elder L.K. (2003). Nutrition of women and adolescent girls: Why it matters. PRB.
  9. 9.
    Rao, S., Yajnik, C. S., Kanade, A., Fall, C. H., Margetts, B. M., Jackson, A. A., et al. (2001). Intake of micronutrient-rich foods in rural indian mothers is associated with the size of their babies at birth: Pune maternal nutrition study. Journal of Nutrition, 131(4), 1217–1224.PubMedGoogle Scholar
  10. 10.
    Scholl, T. O., & Hediger, M. L. (1993). A review of the epidemiology of nutrition and adolescent pregnancy: Maternal growth during pregnancy and its effect on the fetes. Journal of American College of Nutrition, 12, 101–107.CrossRefGoogle Scholar
  11. 11.
    Rah, J. H., Christian, P., Shamim, A. A., Arju, U. T., et al. (2008). Pregnancy and lactation hinder growth and nutritional status of adolescent girls in rural Bangladesh. Journal of Nutrition, 138, 1505–1511.PubMedGoogle Scholar
  12. 12.
    Rah, J. H. (2013). Adolesent pregnancy, its impact on the growth and nutritional status of young mothers: What does evidence say? Sight and Life, 27(3), 37–38.Google Scholar
  13. 13.
    Geronimus, A. T., & Korenman, S. (1992). The Socioeconomic consequences of teen childbearing reconsidered. Quarterly Journal of Economics, 107(4), 1187–1214.CrossRefGoogle Scholar
  14. 14.
    Lenders, C. M., McElrath, T. F., & Scholl, T. O. (2000). Nutrition in adolescent pregnancy. Current Opinion in Pediatrics, 12, 291–296.PubMedCrossRefGoogle Scholar
  15. 15.
    Buvinic, M. (1998). The costs of adolescent childbearing: Evidence from Chile, Barbados, Guatemala, and Mexico. Studies in Family Planning, 29(2), 201–209.PubMedCrossRefGoogle Scholar
  16. 16.
    Rao, S. (2001). Nutritional status of the Indian population. Journal of Biosciences, 26(4), 481–489.PubMedCrossRefGoogle Scholar
  17. 17.
    International Institute for Population Sciences and Macro Internationals. Key findings from National family health survey (NFHS 3). Mumbai, India: International Institute for Population Sciences, 2007. (
  18. 18.
    Sen, S., & Sengupta, N. (2012). Marriage, work and education among domestic workers in Kolkata. Economic & Political Weekly, XLVII, 43, 67–77.Google Scholar
  19. 19.
    Moore, A. M., Singh, S., Ram, U., Remez, L., & Audam, S. (2009). Adolescent marriage and childbearing in India: Current situation and recent trends. New York: Guttmacher Institute.Google Scholar
  20. 20.
    Ministry of Health and Family Welfare. (2000). National Population Policy 2000. New Delhi: Government of India.Google Scholar
  21. 21.
    Santhya, K. G., Jejeebhoy, S. J., & Ghosh, S. (2008). Early marriage and sexual and reproductive health risks: Experiences of young women and men in Andhra Pradesh and Madhya Pradesh, India. New Delhi: Population Council.Google Scholar
  22. 22.
    Santhya, K. G., Ram, U., Acharya, R., Jejeebhoy, J. S., Ram, F., & Singh, A. (2010). Associations between early marriage and young women’s marital and reproductive health outcomes: Evidence from India. International Perspectives on Sexual and Reproductive Health, 36(3), 132–139.PubMedCrossRefGoogle Scholar
  23. 23.
    Prakash, R., Singh, A., Pathak, K. P., & Parasuraman, S. (2011). Early marriage, poor reproductive health status of mother and child well-being in India. Journal of Family Planning Reproductive Health Care, 37(3), 136–145.PubMedCrossRefGoogle Scholar
  24. 24.
    Jejeebhoy, S. J. (1998). Adolescent sexual and reproductive behavior: A review of the evidence from India. Social Science and Medicine, 46(10), 1275–1290.PubMedCrossRefGoogle Scholar
  25. 25.
    Barua, A., & Kurz, K. (2001). Reproductive health-seeking by married adolescent girls in Maharashtra India. Reproductive Health Matters, 9(17), 53–62.PubMedCrossRefGoogle Scholar
  26. 26.
    Santhya, K. G., & Jejeebhoy, J. S. (2003). Sexual and reproductive health needs of married adolescent girls. Economic and Political Weekly, 38(41), 4370–4377.Google Scholar
  27. 27.
    Santhya, K. G., & Jejeebhoy J. S. (2007). Young people’s sexual and reproductive health in India: Policies, programmes and realities. Regional Working Paper No. 19, New Delhi, Population Council.Google Scholar
  28. 28.
    Garn, S. M. (1986). Family-line and socioeconomic factors in fatness and obesity. Nutrition Review, 44, 381–386.CrossRefGoogle Scholar
  29. 29.
    Bouchard, C., Perusse, L., Leblanc, C., Tremblay, A., & Theriault, G. (1988). Inheritance of the amount and distribution of human body fat. International Journal of Obesity, 12, 205–215.PubMedGoogle Scholar
  30. 30.
    UNICEF. (2010). Child protection from violence, exploitation and abuse.
  31. 31.
    Makinson, C. (1985). The health consequences of teenage fertility. Family Planning Perspective, 17, 132–139.CrossRefGoogle Scholar
  32. 32.
    World Health Organisation. (2007). Adolescent pregnancy: Unmet needs and undone deeds. Geneva: World Health Organisation.Google Scholar
  33. 33.
    Rao, S., Gokhale, M., Joshi, S., & Kanade, A. (2010). Early life under nutrition and adolescent pregnancy outcome in rural India. Annals of Human Biology, 37(4), 475–487.PubMedCrossRefGoogle Scholar
  34. 34.
    Toteja, G. S., Singh, P., Dhillon, B. S., Saxena, B. N., Ahmed, F. U., et al. (2006). Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India. Food and Nutrition Bulletin, 27(4), 311–315.PubMedGoogle Scholar
  35. 35.
    Bentley, M. E., & Griffiths, P. L. (2003). The burden of anemia among women in India. European Journal of Clinical Nutrition, 57(1), 52–60.PubMedCrossRefGoogle Scholar
  36. 36.
    Ramachandran, P. (1989). Nutrition in pregnancy. In C. Gopalan & S. Kaur (Eds.), Women and nutrition in India. New Delhi: Nutrition Foundation of India.Google Scholar
  37. 37.
    Krasovec, K., & Anderson, A. M. (1991). Maternal nutrition and pregnancy outcomes: Anthropometric assessment. Washington DC: Pan American Health Organisation.Google Scholar
  38. 38.
    Deaton, A., & Dreze, J. (2009). Food and nutrition in India: Facts and interpretations. Economic and Political Weekly, 44(7), 42–65.Google Scholar
  39. 39.
    Sen, Amartya K. (1988). Family and food: Sex bias in poverty. In T. N. Srinivasan & K. P. Bardhan (Eds.), Rural poverty in South Asia (pp. 453–472). New York: Columbia University Press.Google Scholar
  40. 40.
    Dreze, J. (1993). Review: Nutrition and health in rural India. Economic and Political Weekly, 28(7), 276–277.Google Scholar
  41. 41.
    Drèze, J., & Sen, A. K. (2013). An uncertain glory, India and its contradictions. New Delhi: Penguin.Google Scholar
  42. 42.
    Prichard, B., Rammohan, A., Sekhar, M., Parasuraman, S., & Choithani, C. (2013). Feeding India: Livelihoods, entitlement and capabilities. London and New York: Routledge Taylor and Francis.Google Scholar
  43. 43.
    Fajth, G., & Vinay, C. (2010). Conditional cash transfers: A global perspective, MDG Insights, Issue No. 1, February.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Population Studies, Centre for the Study of Regional Development (CSRD), School of Social Sciences (SSS)Jawaharlal Nehru University (JNU)New DelhiIndia
  2. 2.Department of EconomicsThe University of Western Australia (M251)CrawleyAustralia
  3. 3.International Institute for Population SciencesMumbaiIndia

Personalised recommendations