The role of child marriage and marital disruptions on hypertension in women - A nationally representative study from India.

Child marriage is associated with negative health trajectories among women in low- and middle-income countries (LMICs). Marital disruptions in LMICs are also associated with adverse socioeconomic and health outcomes in women. Yet, little is known about the compounded health effects of experiencing both child marriage and marital disruptions. Using nationally representative data from India among women aged 18-49 years, we examined the effects of marital age (i.e., marriage before or after 18 years) and martial disruptions (i.e., widowed/divorced/separated) on the odds of having hypertension. Findings suggest that together, marital disruptions and child marriage increase the risk of hypertension. Specifically, women married as children and who experienced marital disruptions were 1.2 (95% CI: 1.2-1.3) times more likely to have hypertension compared to women who married as adults and currently in marriage. Additionally, among women married as children, those who experienced martial disruptions had a higher risk (AOR = 1.1, 95% CI: 1.0-1.2) of hypertension compared to their currently married peers. These results suggest public health strategies must consider contextual effects of being widowed/divorced/separated among women who were married as children. Simultaneously, prevention initiatives should be strengthened to reduce the incidence of child marriage in LMICs and associated downstream health consequences.

The risk of hypertension among child brides and adolescent mothers at age 20 s, 30 s, and 40 s: Evidence from India.

Hypertension in reproductive age women, particularly in low-and-middle income countries (LMICs) is an area that is less explored. This study assesses the risk of hypertension in relation to two critical women's health issues in the LMICs - child marriage and adolescent childbearing. The health consequences of these issues have been primarily studied in the context of reproductive health. There is a dearth of evidence on the long-term health outcomes associated with these early life events. The current study, by linking child marriage and adolescent motherhood with hypertension in young adult and early middle-aged women, is commensurate with the body of literature that examines the link between potentially early adversity and later life risk of chronic health outcomes. Using the most recent data on 582,358 women aged 20 to 49 years from India, this study examined whether child brides and adolescent mothers at age 20 s, 30 s, and 40 s had a higher risk of having hypertension compared to women who were not married before age 18 years or did not give birth by age 19 years in respective age groups. Estimating multivariable logistic regressions, we found that child brides and adolescent mothers were about 1.2 times more likely to have hypertension later in life. The elevated risk of hypertension among child brides and adolescent mothers were evident at every age group. These results were robust after controlling for various sociodemographic, anthropometric, and behavioral characteristics as well as across urban and rural, and poor and non-poor subgroups.