Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study
Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study
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DOI：
10.1016/s0140-6736(09)60246-4
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发表时间：
2009-05-01
期刊：
影响因子：
168.9
通讯作者：
Silverman, Jay G.
中科院分区：
文献类型：
--
作者：
Raj, Anita;Saggurti, Niranjan;Silverman, Jay G.
背景 童婚是印度社会和经济发展的重大障碍，也是妇女健康的首要问题。我们评估了印度年轻女性中童婚（即 18 岁之前）的流行情况，以及童婚与妇女生育和生育控制结果之间的关系。方法 全国家庭健康调查 3（2005-06）的数据仅限于 20-24 岁印度妇女样本（n=22807），其中 14813 人已经或目前已婚（曾经结婚）。对整个样本的童婚流行率进行了估计。我们使用针对人口统计数据进行调整的回归模型以及针对人口统计数据和婚姻持续时间进行调整的模型来估计曾婚子样本中童婚与生育和生育控制结果之间关系的比值比 (OR)。结果显示，44.5% 的 20-24 岁女性在 18 岁之前结婚，22.6% 在 16 岁之前结婚，2.6% 在 13 岁之前结婚。童婚与第一次生育前未采取避孕措施（调整后 OR 1.37 [95% CI 1.22-1.54]）、高生育率（三胎或三胎以上）(7.40 [6.45-8.50])、24 个月内重复分娩 (3.00 [2.74-3.29])、多次意外怀孕 (2.36) 显着相关。 [1.90-2.94]）、终止妊娠（1.48 [1.34-1.63]）和女性绝育（6.68 [5.78-7.60]）。在控制婚姻期限后，童婚与高生育率、24个月内重复生育、多次意外怀孕、终止妊娠和绝育之间的关联仍然显着。 解读 加强现有政策的执行对于预防童婚至关重要。为减少生育率过高和不良的生育控制结果，迫切需要为童婚妇女、其丈夫及其家庭提供改善的计划生育教育、机会和支持。资助美国国立卫生研究院和印度医学研究委员会。
Background Child marriage is a substantial barrier to social and economic development in India, and a primary concern for women's health. We assessed the prevalence of child marriage-ie, before 18 years of age-in young adult women in India, and the associations between child marriage and women's fertility and fertility-control outcomes.Methods Data from the National Family Health Survey-3 (2005-06) were limited to a sample of Indian women aged 20-24 years (n=22807), of whom 14813 had been or were presently married (ever-married). Prevalence of child marriage was estimated for the whole sample. We used regression models adjusted for demographics, and models adjusted for demographics and duration of marriage to estimate odds ratios (ORs) for the associations between child marriage and both fertility and fertility-control outcomes, in the ever-married subsample.Findings 44.5% of women aged 20-24 years were married before age 18 years, 22.6% were married before age 16 years, and 2.6% were married before age 13 years. Child marriage was significantly associated with no contraceptive use before first childbirth (adjusted OR 1.37 [95% CI 1.22-1.54]), high fertility (three or more births) (7.40 [6.45-8.50]), a repeat childbirth in less than 24 months (3.00 [2.74-3.29]), multiple unwanted pregnancies (2.36 [1.90-2.94]), pregnancy termination (1.48 [1.34-1.63]), and female sterilisation (6.68 [5.78-7.60]). The association between child marriage and high fertility, a repeat childbirth in less than 24 months, multiple unwanted pregnancies, pregnancy termination, and sterilisation all remained significant after controlling for duration of marriage.Interpretation Increased enforcement of existing policies is crucial for prevention of child marriage. improved family-planning education, access, and support are urgently needed for women married as children, their husbands, and their families to reduce the high fertility and poor fertility-control outcomes of this practice.Funding US National Institutes of Health and Indian Council of Medical Research.