Cumulative impact of early maternal marital age during the childbearing period

Child Marriage Laws around the World: Minimum Marriage Age, Legal Exceptions, and Gender Disparities

The marriage of children below 18 is widely recognized in international human rights agreements as a discriminatory global practice that hinders the development and well-being of hundreds of millions of girls. Using a new global policy database, we analyze national legislation regarding minimum marriage age, exceptions permitting marriage at earlier ages, and gender disparities in laws. While our longitudinal data indicate improvements in frequencies of countries with legal provisions that prohibit marriage below the age of 18, important gaps remain in eliminating legal exceptions and gender discrimination.

ASSESSING THE UTILIZATION OF MATERNAL AND CHILD HEALTH CARE AMONG MARRIED ADOLESCENT WOMEN: EVIDENCE FROM INDIA

This study explores the prevalence and factors associated with the utilization of maternal and child health care services among married adolescent women in India using the third round of the National Family Health Survey (2005–06). The findings suggest that the utilization of maternal and child health care services among adolescent women is far from satisfactory in India. A little over 10% of adolescent women utilized antenatal care, about 50% utilized safe delivery services and about 41% of the children of adolescent women received full immunization. Large differences by urban–rural residence, educational attainment, religion, economic status and region were evident. Both gross effect and fixed effect binary logit models yielded statistically significant socioeconomic and demographic factors. Women's education, wealth quintile and region are the most important determinants for the utilization of maternal and child health care services. Health care programmes should focus more on educating adolescents, providing financial support, creating awareness and counselling households with married adolescent women. Moreover, there should be substantial financial assistance for the provision of delivery and child care for married women below the age of 19 years.

Maternal and neonatal complications in mothers aged under 18 years

OBJECTIVE

The aim of this study was to evaluate maternal and neonatal complications in mothers delivering babies when aged younger than 18 years.

METHODS

In this retrospective study, all labors attended during a one-year period at Alzahra Referral Hospital were evaluated for level of risk. We recorded maternal risk factors, including age, type of delivery, health status, and other factors including marital status and familial marriage. Neonates were evaluated according to prematurity, birth weight, and general health status.

RESULTS

There were 186 mothers under the age of 18 years, comprising 2.6% of all deliveries at our institution. We divided them in two groups according to age, ie, Group 1 (under 15 years) and Group 2 (15-18 years). Rates of normal vaginal delivery and cesarean section were 83% and 17%, respectively. The prevalence of eclampsia and pre-eclampsia in Group 1 was twice that in Group 2. Rates of still birth, prematurity, low birth weight and very low birth weight were higher in Group 1 than in Group 2 (9.09%, 18.1%, 16.7%, and 4.5% versus 4.6%, 13.9%, 13.6%, and 1.9%, respectively). The rate of familial marriage was 18%, and 16% of the offspring of these marriages were complicated by congenital malformations and still birth. These complications were twice as common in Group 1 compared with Group 2 (11% versus 5%, respectively).

CONCLUSION

Maternal age under 18 years is a risk factor for complications in both mothers and neonates, and even more so in mothers aged younger than 15 years.

Change and continuity: childbirth and parenting across three generations of women in the United Arab Emirates

BACKGROUND

The United Arab Emirates (UAE) is a country that has undergone remarkable physical, economic and social shifts in its short modern history. And while the economic and structural transformations of the society have been well documented and publicized, information about the changes and transformations of family processes is sparse. This study is one of the first steps towards documenting the changes in family processes, namely those related to childbirth and parenting, as described by three generations of Emirati women.

METHODS

Family triads of Grandmothers, Mothers and married Daughters (n = 216) were interviewed in local Arabic dialect by Emirati female research assistants. Data were analysed using chi square and Analysis of Variance.

RESULTS

Generational differences were found between the Grandmothers, Mothers and Daughters in: number of births, maternal age at first birth, location and type of birth attendant, medication during labour and birth, father presence at birth, social support following birth, feeding and weaning of infant, and preventive infant health care. Changes were not found in the proximity to the mother of the infant during sleep.

CONCLUSIONS

The age of first birth has risen for Emirati women and the birth rate may have dropped. Health care has also significantly improved. These results are discussed in relation to government initiatives and physical and social change within the UAE and the Middle East.

Cross-national variation in family influences on child health

Drawing on the family process literature, child health models, and recent studies of macro-level effects on health, we examine the effects of household structure, resources, care-giving, reproduction, and communication on child nutritional status and infant mortality. Using Demographic and Health Surveys, we analyze the influence of these factors across 42 countries in Latin America, Africa, and Asia. We also consider country-level including nontraditional family structure, level of economic development and expenditures on health care. Our results underscore the importance of family resources, decision-making, and health and feeding practices on child well-being in less developed countries. Although there is cross-national variability, the size of the variability was small relative to the overall effect. The country-level measures had modest effects on infant mortality and child nutritional status.

Palestinian refugee conditions associated with intestinal parasites and diarrhoea: Nuseirat refugee camp as a case study

OBJECTIVE

To assess the socioeconomic-demographic, environmental health and hygiene conditions associated with intestinal parasites and diarrhoea in Nuseirat Refugee Camp of Gaza Strip.

METHODS

A cross-section of 1625 households were surveyed. A stratified sample was used and drawn from the eight Blocks. Face-to-face interviews were administered for data collection. Piloted and validated questionnaires along with specific checklists were used as instruments.

RESULTS

A total of 485 women interviewed (29.8%) reported intestinal parasites among their household members; 223 (13.7%) admitted cases of diarrhoea. The highest prevalence of intestinal parasites (24.1%) was found among children aged 1-4 years; the highest prevalence of diarrhoea (10.6%) was found among children younger than 1 year. Intestinal parasites were strongly associated with crowding, source of drinking water and the cleaning of water tanks, and were significantly higher among families with unclean homes. Diarrhoea was strongly associated with source of drinking water, a full-day water supply and cleaning of water tanks, and was significantly higher among families with a presence of mosquitoes and garbage around their homes.

CONCLUSIONS

Poor socioeconomic-demographic, environmental health and hygiene conditions play a major role in the occurrence of intestinal parasites and diarrhoea. Children younger than 5 years are at high risk. Real interventions, such as health education, environmental awareness, community involvement and raising funds for infrastructural development are urgently needed.

Maternal smoking during pregnancy and severe antisocial behavior in offspring: a review

OBJECTIVES

Recent research suggests that in utero exposure to maternal smoking is a risk factor for conduct disorder and delinquency. We review evidence of causality, a controversial but important public health question.

METHODS

We analyzed studies of maternal prenatal smoking and offspring antisocial behavior within a causal framework.

RESULTS

The association is (1) independent of confounders, (2) present across diverse contexts, and (3) consistent with basic science. Methodological limitations of existing studies preclude causal conclusions.

CONCLUSIONS

Existing evidence provides consistent support for, but not proof of, an etiologic role for prenatal smoking in the onset of antisocial behavior. The possibility of identifying a preventable prenatal risk factor for a serious mental disorder makes further research on this topic important for public health.

An epidemiological study of childhood disability in Jeddah, Saudi Arabia

Childhood disability is a major health problem that is pronounced in developing countries. The objectives of this study were to identify the maternal risk factors present in our society and their impact on acquiring a disabled child. Data were collected from the six governmental rehabilitation institutes and a sample of normal non-disabled school children in Jeddah City. Information on sociodemographic factors and maternal risk factors was collected by in-person interview and copied from the children's institute records. Logistic regression models were fitted to calculate the adjusted odds ratios in order to demonstrate the impact for the various maternal risk factors on having a disabled child. Our results have shown that certain modifiable maternal risk factors affecting child health still exist in our community, such as early and late-age marriage and childbearing, as well as low education, unemployment, multiparity and consanguineous marriages. All these risks were shown to put the mother at higher risk of having an auditory disabled child. Also, older-age childbearing (> or = 30 years), low education level and multiparity were the maternal risk factors identified that influenced the risk of visual disability in children. Similar maternal risk factors, in addition to unemployment, were more observed among mothers of mentally disabled children. A huge effort is required to discourage the potential risk factors in our community that influence child health.