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Teenage births and final adult height of mothers in India, 1998-1999
Abstract
This paper investigates the statistical association between teenage births and the physical growth path of these mothers. It draws on data on the height of ever-married women aged 15-49 and their birth histories collected in India's National Family Health Survey in 1998-99, and shows that there was a negative relationship between final adult height of women and the number of births they had as teenagers. Using multiple regression analysis, it is shown that this negative relationship is robust to confounding factors such as standard of living, urban-rural residence, state of origin in India and age of the women.
... Majority of adolescent girls get married and are pressurised to have a child (UNFPA, 2013). The main cause of teenage pregnancy in South Asia was reported to be poor socio-economic status, low educational achievement, cultural taboos and family structure (Brennan et al, 2005, p.37). ...
... Vol.3. No. ...
p> Teenage pregnancy and childbirth is a social problem in many Asian countries including Nepal. Many quantitative studies have been done on teenage pregnancy, its outcomes, and challenges faced by teenager, but very little are known about their perceptions and experiences about teenage pregnancy and their consequences during childbirth. This study aimed to explore the perceptions and experiences of teenage pregnancy and childbirth among teenage mothers. This study has adopted phenomenology approach to explore the perceptions and experiences of being a teen mother. Study was based on data collected through in-depth interviews (IDIs), and Focus Group Discussion (FGDs). All respondents provided verbal as well as written consent to face the interview. IDI guide was used to collect information among teenage mothers to assess their perception and experiences on teenage pregnancy and childbirth. Similar guide was used for FGDs. Collected information was manually processed through qualitative content analysis and grouped into theme and subthemes. The teenage mother understood that teenage pregnancy and childbirth is a risk for both mother and child. A majority of them perceived that low education, poverty, love marriage, family problems, in-laws pressure; cultural prospects are aggravating factors leading to teenage pregnancy. Almost all of the respondents mentioned the negative impact of teenage pregnancy on the health. But very few respondents knew advantages of teenage childbirth. Most of them however knew that the teenage pregnancy can be prevented. Access to family planning services to teenage mothers, community awareness, and government support is needed to reduce teenage pregnancy and childbirth.</p
... [20] There are few studies that have investigated the association between adolescent pregnancy and adult attained height, and the findings are conflicting. Studies of populations in Brazil, India, and the U.S. have reported a significant reduction, ranging from 0.3 to 3.0 cm, in attained height following adolescent pregnancy, [21][22][23] however, two of the studies only found an effect in select groups within their study populations. Another study of a U.S. population found no difference in attained height between girls experiencing an adolescent pregnancy and girls who did not. ...
... cm), two (-0.53 cm) or three (-0.98 cm) births before age 18 y, compared to those who delivered after age 18 y. [23] In a retrospective cohort study using U.S. National Health and Nutrition Examination Survey data from 1999 to 2004, non-Hispanic white women who had their first live birth before age 18 years were 2.97 cm shorter at adulthood (20-30 y) than non-Hispanic white women who gave birth to their first child at 18 y (p = 0.03) (after adjusting for age at menarche), with no differences in final adult height by adolescent pregnancy status among Mexican-American and non-Hispanic black women. [22] In the U.S. National Heart, Lung and Blood Growth and Health Study, Gunderson et al., adjusted for age at menarche and height at 9-10 years of age, and found no difference in adult height between those who did and did not experience an adolescent pregnancy. ...
Importance:
The impact of adolescent pregnancy on offspring birth outcomes has been widely studied, but less is known about its impact on the growth of the young mother herself.
Objective:
To determine the association between adolescent pregnancy and attained height.
Design:
Prospective birth cohort study.
Setting:
Cohort members followed from birth to age 20 y in Soweto, South Africa.
Participant:
From among 840 Black females with sufficient data, we identified 54 matched pairs, in which a girl who became pregnant before the age of 17 years was matched with a girl who did not have a pregnancy by age 20 y. Pairs were matched on age at menarche and height-for-age z scores in the year before the case became pregnant (mean 15.0 y).
Main outcome measures:
The two groups were compared with respect to attained height, measured at mean age 18.5 y.
Results:
Mean age at conception was 15.9 years (range: 13.7 to 16.9 y). Mean height at matching was 159.4 cm in the adolescent pregnancy group and 159.3 cm in the comparison group (p = 0.3). Mean attained height was 160.4 cm in the adolescent pregnancy group and 160.3 cm in the comparison group (p = 0.7).
Conclusions:
Among Black females in Soweto, South Africa, adolescent pregnancy was not associated with attained height.
... These findings were is in line with some studies which find some medical consequences linked with teenage pregnancies as pre-term delivery, still birth, birth asphyxia, anaemia, low birth weight, pregnancy induced hypertension (PIH) and spontaneous abortion were most frequently encountered complications during teenage pregnancy [29; 27]. Regarding dropping out of school and single parenting, this finds is supported by further findings by [29][30][31][32], who reported Lower access to higher education, high divorce rates, weak and single motherhood as negative consequences of teenage pregnancy. ...
Adolescent pregnancy and subsequent childbirth to women less than 19 years have continued to constitute a major global public health concern, affecting more than 16 million girls and young women worldwide. These high teen pregnancy rates have health impacts. In Uganda, it is the leading cause of death and disability among Ugandan women 15 to 19 years. The objective of this study was to determine the factors associated with early pregnancies among adolescent girls attending selected health facilities in the Bushenyi district. The research design was cross-sectional and descriptive using the quantitative method for data collection. Ninety-eight (98) respondents participated in this study. Data were analyzed using SPSS, descriptive, bi-variate and multivariate analyses at a 95% confidence interval. The findings of this study show that the age of a teenager, place of residence, marital status, education status of teenagers, teenagers' parent's education status, occupation of teenagers' occupation and marital status are the socioeconomic factors that are significantly associated with early teenagers or adolescent pregnancies are the socioeconomic factors associated with early pregnancies among adolescent girls attending selected health facilities in Bushenyi district. Teenagers between the ages 16-17 years have 60% higher odds (OR= 1.60) to get pregnant compared with teenagers between ages 18-19years and most of these teenagers do not use contraceptives hence are 2 times (OR=2.20) more likely to get pregnant compared to those who use. Also, most teenagers in Bushenyi district have early sex in order to belong or be accepted among their peers and this has resulted in most unplanned pregnancies. The likely consequences associated with early pregnancies among adolescents in the Bushenyi district include; dropping out of school 34 (34.7%), single parenting 28 (28.6%), health complications 15 (15.3%) and stigmatization 12 (12.2%). Sex education and sensitization should be included in schools' curricula in order to educate teens on sex and reproductive health early enough.
... Studies carried out in 1990s observed that, among over one million female teenagers, 1 out of 10 over the age 15 became pregnant each year, and approximately 50% of these teens gave birth, while 40% had abortions (Hillard, 1990;Institute, 1994;Moore, 2001). There are many reasons for teenage pregnancy in the literature such as early age menarche (Chen et al., 2007), early first sexual activity age (Satin et al., 1994), absence of a biological father (Ellis et al., 2003), socio-economic status, educational attainment, cultural factors and family structure (Brennan, McDonald, & Shlomowitz, 2005;Ganatra & Hirve, 2002;Goonewardene & Waduge, 2009;A. Sharma, Verma, Khatri, & Kannan, 2001;A. ...
... From an evolutionary perspective, early growth faltering reflects both inadequate maternal nutrition, but also the diversion of nutritional resources away from growth to other biological functions. In post-natal life, for example, linear growth may be traded off first against immune function [62] and subsequently against earlier reproduction [63]. Those under-nourished in early life are prone to develop central adiposity if they subsequently gain excess weight [64], which may reflect the role of visceral fat in promoting immune function [65,66]. ...
The major threat to human societies posed by undernutrition has been recognised for millennia. Despite substantial economic development and scientific innovation, however, progress in addressing this global challenge has been inadequate. Paradoxically, the last half-century also saw the rapid emergence of obesity, first in high-income countries but now also in low- and middle-income countries. Traditionally, these problems were approached separately, but there is increasing recognition that they have common drivers and need integrated responses. The new nutrition reality comprises a global ‘double burden’ of malnutrition, where the challenges of food insecurity, nutritional deficiencies and undernutrition coexist and interact with obesity, sedentary behaviour, unhealthy diets and environments that foster unhealthy behaviour. Beyond immediate efforts to prevent and treat malnutrition, what must change in order to reduce the future burden? Here, we present a conceptual framework that focuses on the deeper structural drivers of malnutrition embedded in society, and their interaction with biological mechanisms of appetite regulation and physiological homeostasis. Building on a review of malnutrition in past societies, our framework brings to the fore the power dynamics that characterise contemporary human food systems at many levels. We focus on the concept of agency, the ability of individuals or organisations to pursue their goals. In globalized food systems, the agency of individuals is directly confronted by the agency of several other types of actor, including corporations, governments and supranational institutions. The intakes of energy and nutrients by individuals are powerfully shaped by this ‘competition of agency’, and we therefore argue that the greatest opportunities to reduce malnutrition lie in rebalancing agency across the competing actors. The effect of the COVID-19 pandemic on food systems and individuals illustrates our conceptual framework. Efforts to improve agency must both drive and respond to complementary efforts to promote and maintain equitable societies and planetary health.
... First, early reproduction appears to curtail maternal physical growth. Several studies have shown that adolescent childbearing is associated with a reduced rate of linear growth, indicating that the energy costs of reproduction reduce the allocation of energy to maternal growth (163). Second, several studies have shown a trade-off between weight gain and height gain. ...
Over recent millennia, human populations have regularly reconstructed their subsistence niches, changing both how they obtain food and the conditions in which they live. For example, over the last 12,000 years the vast majority of human populations shifted from foraging to practicing different forms of agriculture. The shift to farming is widely understood to have impacted several aspects of human demography and biology, including mortality risk, population growth, adult body size, and physical markers of health. However, these trends have not been integrated within an over-arching conceptual framework, and there is poor understanding of why populations tended to increase in population size during periods when markers of health deteriorated. Here, we offer a novel conceptual approach based on evolutionary life history theory. This theory assumes that energy availability is finite and must be allocated in competition between the functions of maintenance, growth, reproduction, and defence. In any given environment, and at any given stage during the life-course, natural selection favours energy allocation strategies that maximise fitness. We argue that the origins of agriculture involved profound transformations in human life history strategies, impacting both the availability of energy and the way that it was allocated between life history functions in the body. Although overall energy supply increased, the diet composition changed, while sedentary populations were challenged by new infectious burdens. We propose that this composite new ecological niche favoured increased energy allocation to defence (immune function) and reproduction, thus reducing the allocation to growth and maintenance. We review evidence in support of this hypothesis and highlight how further work could address both heterogeneity and specific aspects of the origins of agriculture in more detail. Our approach can be applied to many other transformations of the human subsistence niche, and can shed new light on the way that health, height, life expectancy, and fertility patterns are changing in association with globalization and nutrition transition.
... Teenage pregnancy is common in India as well as in many south Asian countries since adolescent marriage is a social reality and there is a social expectation to have a child soon after marriage [3][4][5][6]. Many researches show that the ill consequences of adolescent pregnancy are due to marriage in early ages [7] and adverse social and economic conditions of women [8][9][10][11][12][13][14][15][16][17]. Biologically, a teenage pregnant woman, still growing, has to compete with the foetus for nutrients and hence, pregnancy within two years after menarche increases the risk of preterm delivery [18]. ...
Background: adolescent pregnancy has been common in India and it hosts to several health consequences to the mothers and children. a detailed investigation of the prevalence and consequences of adolescent pregnancy is required. This study examines the association of pregnancy outcomes among adolescent women with various socio-cultural, economic and demographic backgrounds. MeThods: This study is based on primary data collected from south-eastern districts of rajasthan, India. The birth outcomes of first order pregnancy have been considered to highlight the adolescent pregnancy. analyses have been done by employing sPss 16.0. resulTs: The study reveals that 15.4 percent of the total first order pregnancies have been reported to have terminated into non-live births. Women who experienced their first pregnancy at 20 and above years of age are 3.889 times (p<0.01) more likely to have live birth outcome than to women who experienced it at 16 years of age. Women belonging to Meena tribe are 1.95 times (p<0.05) more likely to experience live pregnancy outcome than counterpart Bhil women. Women belonging to rich wealth index are significantly 4 times (p<0.01) more likely to give live births in reference to women belonging to poor wealth status. conclusIon: The results demonstrate that considerable share of pregnancies among adolescent women turn into miscarriages and this prevalence is more likely among young, rural, uneducated and poor women than their counterpart women. hence, there is a need to improve the health care system with its focus on educating and counseling adolescents and creating awareness about the complications of teenage pregnancy. The awareness and accessibility of contraceptive methods to adolescents should be ensured through health care system.
The main aim of this paper is to examine the trends and factors affecting teenage pregnancies in Sri Lanka. This paper draws mainly upon secondary data, reviewing the available research findings to describe the patterns, trends and causes for teenage pregnancies in Sri Lanka. When taking into account the trends of teenage pregnancies in Sri Lanka, the percentage of teenage mothers is lower than the other countries in South Asia. However, on the island, the percentage of teenage pregnancy varies from district to district and the prevalence of teenage mothers in certain areas is high. Social factors such as sexual violence, extreme poverty, the impact of war, lack of social opportunities and family conflicts could be identified as the main factors associated with teenage pregnancies. However, patriarchal culture, negative attitudes on poverty, social pressure and misuse of technology or social media as identified in this paper are the root causes for the teenage pregnancies in the country. In order to eliminate the problem of teenage pregnancy, short term and long-term solutions need to be planned. Taking strong actions against gender-based violence, expanding educational opportunities, eradicating poverty and also rehabilitating social systems devastated by the effects of the long-drawn civil war, motivating children and families for engaging with institutions such as schools and religious institutions will be helpful to solve this problem up to some extent. The engagement with the institutions of the health sector should also be implemented in providing sex education, family counselling, and educating parents on alternative income schemes. Awareness programmes in the areas where teenage pregnancies are high also can be implemented and human resources available in the particular area can be utilized for this purpose.
ABSTRACT
Justification: Rigorous research into the patterns and determinants of adolescent pregnancy in Sri Lanka is scarce. Compared to many Western populations and other South Asian countries, levels of adolescent pregnancy are low in Sri Lanka. Nevertheless, anecdotal evidence indicates that pregnancies outside of marriage are stigmatized among large sections of the population and that unwanted adolescent pregnancies, illegal abortions and suicides linked to adolescent pregnancy are a concern. Evidence shows low levels of knowledge and restricted access to contraception for adolescents in Sri Lanka. There is a need for more reliable data on adolescent sexuality and pregnancy encompassing a wider range of views in order to shape a culturally appropriate policy and practice response to meeting the reproductive health needs of Sri Lankan adolescents.
Objective: To understand the context and patterns of adolescent pregnancy and sexual behaviour in a district in Sri Lanka.
Methodology: Population based questionnaire surveys of random samples of pregnant adolescents (n=450, interviewer-administered), their partners (n=150, interviewer-administered) and school going adolescents (n=2,020, self-completion). Descriptive and multivariate analyses were performed for each sample separately, followed by an integration of the data across the three data sources.
Findings: Out of the 450 pregnant adolescents, 409 (91%) were in their first pregnancy. From this 409; 121(30%) were<18 years and 288 (70%) ≥ 18 years old. 263 (64%) pregnant adolescents reported that they had planned their pregnancies and 146 (36%) had not planned. Among the 150 partners, 100 (67%) reported they had planned the pregnancy and 50 (33%) had not planned the pregnancy. Among the 2,020 school adolescents (521 boys and 1,499 girls), just 1.5% of the girls and 8.8% of the boys reported experience of a sexual relationship, and only 0.3% of girls and 5.7% of boys had experienced an intimate sexual relationship.
Adolescent pregnancies, whether planned or unplanned, were found to be largely welcomed, and adolescent pregnant girls were living within stable and supportive family environments. Pregnant adolescents parents’ low education level, parents having married earlier than 18 years, and pregnant adolescents’ siblings having children were more apparent compared to the school adolescent girls hinting that pregnant adolescents are from a subculture within which early childbearing is the norm.
Conclusions and Recommendations: Findings confirm that pre-marital adolescent sexual activity was not generally condoned and remains rare. Relationships are predominantly monogamous. Gender difference in sexual activity exists. Reproductive health knowledge was very low across the samples and requires attention. Although the majority of pregnancies were planned and welcomed, given the inter-generational consequences of early childbear¬ing, policy makers must find ways to tackle the structural and cultural factors that hamper a shift towards later childbearing among certain sections of the population. A proper collaboration between the education, health and community action can harness a long-term sustainable adolescent risk reduction and adolescent development. The difference of the age of consent (16 years) and the legal age of marriage (18 years) require policy debate.
This paper draws on data from the National Family Health Survey of 1998-99 to investigate the correlates of the height of Indian women.
To investigate the determinants of low birth weight in infants born to adolescent mothers, we studied the obstetric population attended at the Maternity Hospital of Lima, Peru. From this population, 1256 gravidas, ranging in age from 12 to 25 years, volunteered to participate in this study. Anthropometric and biochemical measurements were used to evaluate the nutritional status and physiological maturity of the mother and newborn. For analytical reasons the young teenaged mothers (less than 15 years) were classified as either still-growing or having completed their growth, depending on their height relative to their parents' height. Similarly, the young teenagers were classified as either gynecologically immature or gynecologically mature depending on whether their gynecological age was less than or greater than 2 years.
Our results indicate that young still-growing teenagers, even when matched for nutritional status, have smaller newborns than adult mothers. The data also demonstrate that maternal gynecological age per se does not affect prenatal growth. As inferred from multivariate analyses, it appears that the reduction in birth weight among young teenagers can be explained in part by a decreased net availability of nutrients resulting from the competition for nutrients between the mother's growth needs and the growth needs of her fetus and by an inability of the teenage placenta to maintain placental function adequately for active fetal growth.
The second section of this paper set forth a theoretical model relating adolescent growth and development to family formation patterns and their implications for maternal and child health. Subsequent sections of the paper examine the evidence to support specific relationships hypothesized in the model, focusing on longitudinal data from Matlab, Bangladesh. Despite the emphasis on developing country populations, literature from developed countries was also reviewed. The weight of the evidence suggests that in the developed countries, while there is a positive relationship between reproductive maturation and subsequent reproductive behavior, the negative effects of young maternal age on pregnancy outcome is confounded with socioeconomic factors. Teenage pregnancy, or at least teenage birth, occurs disproportionately among the socially and economically disadvantaged. Moreover, teenage childbearing in the U.S., especially when it occurs outside of marriage, violates social norms, at least in the white population. Poor diet may be a problem in the U.S. but it does not appear to result in notable delays in physical growth and development, delayed or compromised adolescent growth, or late age at menarche. Limited evidence suggests that early menarche may be associated with more rapid onset of mature menstrual cycle activity but these findings have not been replicated elsewhere. In developing countries the situation is quite different. First, early marriage and childbearing are desired and common across most segments of society. Second, malnutrition is widespread, and is sufficiently severe to delay the adolescent growth spurt and raise average age at menarche by two to three years compared with developed country populations. This is certainly the case in Bangladesh. In this setting, several observations regarding the relationship of nutritional status, adolescent development and reproduction have been made. First, undernutrition delays growth and reproductive maturation, and women who mature early (i.e., women with young age at menarche) marry at younger ages than later maturers. In addition, body weight appears to have an independent effect on age at marriage, net of age at menarche, such that relatively heavy women marry at younger ages than their lighter counterparts. Explanations for this finding include correlation between body weight and development of secondary sex characteristics, and perhaps a cultural perception that heavier (i.e., normal body weight) women are more attractive, or healthier, mates. The effect of menarche and nutritional status on marriage gives rise to concern that an improvement in nutritional status, and an increase in the age at menarche, would lead to younger marriage and first birth, and higher lifetime fertility.(ABSTRACT TRUNCATED AT 400 WORDS)
During the first half of the 20th century, chronic energy undernutrition due to low dietary intake, repeated infections, and rapid succession of pregnancy were the factors most responsible for maternal undernutrition and consequent adverse outcomes of pregnancy. Efforts to improve dietary intake, treatment of infections, and provision of contraceptive care were the major focuses of intervention from 1950 to 1990. These interventions resulted in reduction in severe grades of undernutrition. However, there was no reduction in mild and moderate degrees of undernutrition and anemia during pregnancy and there was no significant improvement in the course and outcome of pregnancy, or in birth weight. During the 1990s, among the middle- and upper-income groups, there has been a progressive rise in obesity and consequent adverse effects. The advent of HIV infection in India in the 1980s will inevitably lead to increases in severe undernutrition associated with HIV infection in pregnancy and an adverse impact of maternal HIV infection on the fetus. Practicing physicians and nutritionists in the new millennium will therefore have to assess each person individually and provide appropriate advice regarding diet, exercise, fertility, and infection prevention and control in order to achieve optimum health and nutrition status during pregnancy and to prevent adverse pregnancy outcomes.