Department of Sociology and Anthropology, National University of Singapore, Singapore.
Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore.
Int J Epidemiol. 2023 Oct 5;52(5):1303-1315. doi: 10.1093/ije/dyad051.
Child marriage, defined as marriage under the age of 18 years, remains pervasive in India. Global evidence documents a negative association between child marriage and women's reproductive and sexual health outcomes; however, its relationship with non-communicable diseases (NCDs) remains underexplored.
We utilize biomarkers and self-reported data from the nationally representative National Family and Health Survey 4 (2015-2016) to examine the associations between child marriage and hypertension, diabetes, heart disease, asthma and thyroid disorder among currently married women (N = 421 107). We use regression models adjusted for a range of demographic and socio-economic controls to assess the association between child marriage and NCDs among women in India. We further assess whether and to what extent these relationships are mediated by early motherhood using the Karlson, Holm and Breen method of decomposition.
Child marriage was associated with hypertension [adjusted odds ratio 1.20 (95% CI: 1.17-1.24)], diabetes [1.29 (1.22-1.37)], heart disease [1.27 (1.18-1.36)], asthma [1.19 (1.11-1.28)] and thyroid disorder [1.10 (1.02-1.18)]. Early motherhood also increased the risk of NCDs among women. Furthermore, it emerged as a pathway linking child marriage with hypertension, diabetes and heart disease; however, it provided a partial explanation for the disadvantage associated with child marriages.
Child marriage emerges as a risk factor for NCDs among women in India. Health systems need to recognize the enduring influence of child marriages on women's health and ensure early detection and effective treatment of NCDs for this vulnerable group.
在印度，18 岁以下的婚姻仍被普遍认为是童婚。全球证据表明，童婚与妇女的生殖和性健康结果呈负相关；然而，其与非传染性疾病（NCDs）的关系仍未得到充分探索。
我们利用具有全国代表性的国家家庭健康调查 4（2015-2016 年）中的生物标志物和自我报告数据，研究了童婚与目前已婚妇女中的高血压、糖尿病、心脏病、哮喘和甲状腺疾病之间的关联（N=421107）。我们使用回归模型，调整了一系列人口统计学和社会经济控制因素，以评估童婚与印度妇女 NCDs 之间的关系。我们进一步评估了这些关系是否以及在多大程度上通过早期生育来介导，并使用 Karlson、Holm 和 Breen 方法进行分解。
童婚与高血压相关[调整后的优势比 1.20（95%置信区间：1.17-1.24）]、糖尿病[1.29（1.22-1.37）]、心脏病[1.27（1.18-1.36）]、哮喘[1.19（1.11-1.28）]和甲状腺疾病[1.10（1.02-1.18）]。早期生育也增加了妇女患 NCDs 的风险。此外，它成为童婚与高血压、糖尿病和心脏病相关的一个途径；然而，它仅为童婚相关劣势提供了部分解释。
童婚成为印度妇女 NCDs 的一个风险因素。卫生系统需要认识到童婚对妇女健康的持久影响，并确保为这一弱势群体及早发现和有效治疗 NCDs。
