Teen pregnancy in India linked to child stunting: study

Children born to teenage mothers in India are more likely to be stunted than those born to adult moms, according to the first comprehensive study to examine links between teen pregnancy and child undernutrition in the country.

India is home to more stunted children than any other country and is one of the ten countries with the largest burden of teenage pregnancy, said researchers at the US-based International Food Policy Research Institute (IFPRI).

Although marriage before the age of 18 years is illegal in India, the 2016 National Family and Health Survey (NFHS)-4 revealed that 27 per cent of girls are married before their 18th birthday and 31 per cent of married Indian women gave birth by the age of 18 years.

"Reducing adolescent pregnancy in India can hasten our progress towards achieving the United Nations' Sustainable Development Goals, particularly those related to poverty, health, nutrition, general wellbeing, equity, and education," said IFPRI Research Fellow and study co-author, Phuong Hong Nguyen.

The study, published in The Lancet Child and Adolescent Health, analysed data from 60,097 mother-child pairs and examined the extent to which teenage pregnancy is associated with child undernutrition.

They also explored potential social, biological, and programmatic factors linking early pregnancy to child undernutrition.

The study found that stunting and underweight prevalence were 10 percentage points higher in children born to adolescent mothers than in children born to adult mothers.

"Our study sheds empirical light on pathways between teenage pregnancies and child undernutrition," said study co-author Samuel Scott.

"People have talked about these pathways before, but this data allowed us to put some numbers to those pathways," Scott said.

Compared to adult mothers, teenage mothers were shorter, more likely to be underweight and anaemic, less likely to access health services and had poorer complementary feeding practices.

They also had lower education, less bargaining power and lived in poorer households with poorer sanitation.

"The strongest links between adolescent pregnancy and child stunting were through the mother's education, her socio-economic status, and her weight," said Scott.

Researchers said there is a very clear single, but not simple, policy target to address the problem: ending early marriage.

Policies and programmes to delay marriage can potentially help break the intergenerational cycle of undernutrition through many routes, they said.

"Unfortunately, in India, early marriage and subsequent pregnancy is often not a deliberate choice, but rather the result of an absence of choices, and of circumstances beyond a girl's control," said IFPRI Senior Research Fellow and study co-author, Purnima Menon.

The Teenage Girls Survey 2018 (TAG Survey) by Naandi Foundation, a direct conversation with girls across India, shows that 73.3 per cent of teenage girls want to marry only after the age of 21, but also highlights the mismatch between their aspirations and the reality of early marriage, researchers said.

"Continuing schooling, exploring employment opportunities, and delaying marriage and pregnancy are challenges for India's girls that are reinforced through patriarchy and social norms," said Menon.

"We are very encouraged by the decline in the prevalence of early marriage over the last decade but also puzzled by why it is high in states like Andhra Pradesh and Telangana," she added.