Impact of Early Childbearing on the Health of the Mother and Child: A Statistical Study

Abstract

Recent research has document the focus of rapidly growing interest on adolescents’ and their child health in the developing and under developed countries because of its important implications not only for the health of mother but also their children. Early childbearing is an important indicator for women’s and their child health. Body mass index is an indicator of nutritional status in a population. This indicator provides the circumstances that can assist intervention to help eradicate many preventable diseases. Health impact of teenage childbearing is not only due to socio-demographic factors but also due to biological factors. Women early age at first marriage were associated with early childbearing and early childbearing is considered as a risk factor for poor prenatal outcomes. There is a need to study demographic trends particularly trends in marriage under the framework of “basic need strategy”. The objectives of “basic need strategy” among others are to eradicate poverty, unemployment, hunger and literacy is considered as a major precondition for achieving population goals and the participation of women in development. The main objective of this study is to evaluate and analyze the impact of early childbearing on the mother and their child health of rural and urban community in Bangladesh. The specific objectives were: first one, to find the effect of socio-demographic factors on early childbearing mother’s health; second one, to investigate the changes in age at first marriage of Bangladeshi women over time and third one, to estimate the parameters involving in the age patterns of marriage and evaluate the patterns (using single year age distributions) of distributions of first marriage frequencies and risks of the first marriages of ever married women in Bangladesh. Finally, the purposes of the study were to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and to find some predictors of child malnutrition in Bangladesh. Considering the reproductive women (age 15-49 years), data was extracted from Bangladesh Demographic and Health Survey in this study. For measuring mothers’ health a sample of 1908 ever-married women of age 10-24 were used from the total sample of 10,966. For investigate the age at first marriage and its trends over time, data for 47,109 married Bangladeshi women from 1944-1985 were analyzed. To estimate the parameters of Coale’s nuptiality model and evaluate the patterns of distributions of first marriage frequencies also risks of the first marriages of ever married women in Bangladesh, eventually all of 10,996 ever married women from age 15 to 49 years were taken. To examine the health problem and risks faced by early childbearing mothers’ children in Bangladesh a total sample of 3,207 were extracted. Logistic regression was used to examine the relative importance of socio-demographic factors on early childbearing mothers’ health. ANOVA and linear regression analysis were used to investigate the changes in age at first marriage of Bangladeshi women over four decades. The first marriage frequency and risk of first marriage of women was estimated by Coale and McNeil (1972) model. This model considered five year age group of population. In the present study single year age distribution of ever married female in Bangladesh has been considered. Finally for measuring child health Chi-square test and GPR model were used. More than 33 percent early childbearing mothers have been suffering from chronic energy deficiency, among them 35.4 percent came from rural and 26.9 percent from urban. The BMI varied from 11.95 kg/m2 to 37.79 kg/m2, with a mean of 19.86 ± 2.70 kg/m2 (95% CI: 19.74-19.98). About 15.7 percent women fall below the cutoff of 145 centimeters in height. A decreasing trend was found in the number of CED women with increasing educational level. Student t-test revealed that caesarean mother had a higher BMI than non-caesarean mother (p < 0.001. The coefficients and odds ratio of logistic regression analysis demonstrated that early childbearing mothers who were from rural areas, illiterate, hard laborer, unemployed partner, poorest, non-caesarian, delivered at home, earlier age at first marriage, early age at first birth, having two or more children, were at higher risk for getting chronic energy deficiency (underweight). Based on Wald statistics (16.258) we conclude that age at first marriage was the most influential variable on early childbearing and undernourished mother in Bangladesh. The mean and median age at first marriage of ever married Bangladeshi women was 14.73 ±2.96 years and 14.00 years, respectively; rural women got marriage significantly (p<0.01) earlier than urban women. More than 85 percent (rural 87.6 percent and urban 78.2 percent) Bangladeshi women got marriage before they reached 18 years old, among them 17.0 percent (rural 18.5 percent and urban 13.1 percent) got marriage very early age (before 13 years old). The present study demonstrated that the age at first marriage of ever married Bangladeshi women was showing increasing tendency with changing time. Using ANOVA, age at first marriage for rural and urban showed significant (p<0.01) differences among the birth year cohorts from 1944 to 1985 of the present sample. However, the slope of linear regression line indicated that age at first marriage for both rural and urban women exhibited increasing tendency during the investigated period. Also, the present study demonstrated that the child marriage among Bangladeshi women showed slightly decreasing tendency during birth year cohorts from 1944 to 1985. Coale’s model was used to find the age pattern of marriage among Bangladeshi women. The model gave us interesting results. Most of female got married before the age of 20 years with almost 100 percent getting married by the time they reach age 30. In Bangladesh the legal age of marriage is 18 years old for the women; however a large proportion (about 95 percent) of marriages below this age still take place. The GPR model has been found to be reasonable to study the outcome variable because of its under-dispersion (variance < mean) property. Our study also identify several significant predictors of the outcome variable namely; region, place of residence, father’s and mother’s education, mothers occupation, wealth index, delivery system, place of delivery, source of drinking water of the household, toilet facility, and total number of children ever born to a woman. These above results suggest that for improving health status of Bangladeshi early childbearing mothers, are need to improve the literacy. The result also suggest that age at first marriage of Bangladeshi women has been increasing for last four decades, and increasing rate of urban women is faster than rural women. Moreover, the study confirms that marriage still remains a universal phenomenon among females in Bangladesh. Early marriage prevails that marriage not only start early but progresses fast and are concentrated within a short span of time at least in the female population. Consistencies of our findings we suggest that the GPR model is an ideal alternative of other statistical models for analyzing child malnutrition in a family.