Marriage is entry in to reproductive life in Indian Society. It has been observed that states like Uttar Pradesh, Bihar, Jharkhand, Madhya Pradesh, Rajasthan and Chhattisgarh experiencing early age at marriage before reaching age 18 years. Early age at marriage leads to early child birth and repeated deliveries.With the above concept in view an attempt is made in this study to know the influence of early marriage among currently married Adolescent women and their reproductive loss and reproductive health problems in EAG states. Further to know the influence of socio economic variables on reproductive risk factors by using NFHS-3 data.

1. Influence of Early Marriage
on Reproductive Health risk
among Adolescent women in
EAG States in India:
Evidences from NFHS-3 Data
Prof . C.P.Prakasam
prakasam60@gmail.com

2. Research Studies reveals:
 Young Women who had married early (<18 years of
age) were more likely to have had a miscarriage or
stillbirth than women married late.
 Early marriage and early conception will influence
early delivery, repeated deliveries, risks among
adolescent mother, influence Infant and maternal
mortality, sexual violence and reproductive health
problems.

3. Objectives
 To examine the influence of early age at marriage
among adolescents on reproductive loss in EAG states
viz; Bihar, Madhya Pradesh, Uttar Pradesh, Rajasthan,
Chhattisgarh and Jharkhand.
 To examine the reproductive morbidity among early
married women among EAG
 To understand the interrelation between early
marriage and Reproductive loss and reproductive
morbidity (Reproductive risk variables) in these EAG
states.

4. Data :
 Data for the present study has been drawn from
NFHS-3 for the EAG states: Bihar, Madhya Pradesh,
Uttar Pradesh, Rajasthan, Chhattisgarh and
Jharkhand.
 Women with current age 15-22 considered as
Adolescent
 Women with age at marriage <18 years considered as
Early married women (EAM) and women married
between 18-22 years as late marriage (LAM).

5. Adolescent Women (NFHS-3)
 Married women less than 22 years of age in the EAG
States.
 Bihar: 418
 Madhya Pradesh:485
 Uttar Pradesh: 1033
 Rajasthan: 379
 Chhattisgarh: 323
 Jharkhand: 369

6. Variables:
 The set of variables classified in to three categories:
1. Reproductive Health Variables
2. Reproductive Loss
3. Reproductive Morbidity variable.
Marriage: Early (<18 years) and Late (18-22 years)

7. Age at Marriage ,Reproductive History, Reproductive loss and Reproductive
Morbidity variables among Adolescents in EAG States: List of Variables:
NFHS-3 Data
Category of Variables Description of Variable Code
Influencing Variable Age at Marriage < 13 years, 14-17 years
18-22 years
Reproductive History
Variables
Firth Birth Interval in Years
Birth during Last 5 years
Currently Pregnant
Marital Duration
<1 , 1-2, 2-3,4-5 years
No,One,Two,3-5 births
Yes , No
1-4 years, 5-9 years
Reproductive Loss Total Children ever born
Survival Status (Ratio)
Ever Terminated pregnancy
One,2-3,4-5
Child Loss, Child Survived
Yes , No
Reproductive Morbidity Had any STD in Last 12 months
Had Genital Sore in last
12months
Had Genital Discharge in Last 12
Months
Yes , No
Yes, No
Yes , No

8. Percent Adolescent Married in EAG States:NFHS-3 Data
84
79.6 78.9
75.5
83
73.7
0
10
20
30
40
50
60
70
80
90
Bihar Uttar
Pradesh
Rajasthan Madhya
Pradesh
Chhatisgarh Jharkhand
<13y
14-17y
18-22 y

9. Percent adolescent women (15-22 years) according to Reproductive History,
Reproductive loss and Reproductive morbidity in EAG states : NFHS-3 Data
Rep. History Rep . Loss Reproductive Morbidity
States
First
Birth
interval
(<2y)
Birth During
Last 5 y
(Two Births)
Child loss Had STD Had
Genital
Sore
Had
Genital
Discharge
BIHAR 82.7 93.3 12.2 3.6 3.1 12.7
Madhya
Pradesh 81.3 94.4 14.6 6.0 4.1 19.8
Uttar Pradesh 83.9 91.3 14.1 2.2 1.6 11.9
Rajasthan 74.4 93.1 11.9 0.8 0.8 11.6
Chhattisgarh 85.5 93.5 16.4 0.3 1.9 5.6
Jharkhand 85.4 95.4 13.6 1.9 3.0 11.1

10. Interrelation between Age at marriage and
Reproductive risk variables
 Background Variables: Current age – respondent, Marital
duration
 RH variables: Age of the respondent at first birth, No. Living
Children, First Birth interval, Births in last five years
 Reproductive Loss: CEB/CS, Ever had terminated pregnancy,
Daughters who have died and Sons who have died.
 Nutrition Status: Anemia Level

11. Correlation coefficient between background variable, out come of delivery, Reproductive
loss with Age at Marriage (EAM/LAM) among Adolescent women in EAG States-NFHS-3 data
BIHAR MADHYA
PRADESH
UTTAR
PRADESH
Rajasthan Chhattisgarh Jharkhand
BG Current age - respondent
.355** .234** .336** .310** .313** .312**
BG Marital duration
-.408** -.605** -.509** -.559** -.519** -.476**
RH Age of respondent at 1st birth
.744** .789** .783** .770** .796** .798**
RH Number of living children
-.294** -.441** -.337** -.350** -.384** -.266**
RH First birth interval
-.203** -.357** -.270** -.311** -.281** -.239**
RH Births in last five years
-.233** -.387** -.299** -.286** -.327** -.223**
RL Total children ever born
-.298** -.465** -.362** -.368** -.396** -.310**
RL Survival Status (Ratio)
.008 .162** .130** .114* .088 .200**
RL Ever had a terminated pregnancy
-.062 -.091** -.091** -.078* .009 -.141**
RL Daughters who have died
-.073 -.168** -.150** -.150** -.065 -.167**
RL Sons who have died
-.037 -.133** -.082** -.082* -.106* -.122**
Nu Anemia level
.032 .158** .027 .037 -.007 .144**

12. Correlation Analysis:
 Correlation analysis shows that Background Variables
and Reproductive Health variables are significantly
correlation with Age at marriage in all these EAG
states.
 Reproductive loss (RL) variables could not show
significant relation with Age at marriage in Bihar.
 Anemia level is an indication of mother’s nutritional
status which is a composite indicator of repeated
pregnancy, child loss , poverty and other biological
and physical factors.
 Anemia is significantly, positively correlated with age
at marriage in Madhya Pradesh and Jharkhand only.

13. Risk Ratio
 To understand the risk of reproductive health variables
among Early marriage/Late married adolescent
women, Relative risk ratio has been calculated:
Relative Risk (RR):
Incidence of RH problem among adolescent married women experienced EAM
----------------------------------------------------------------------------------------------
Incidence of RH problem among adolescent married women who are not experienced EAM
RR equal to “one” indicates that the incidence of Reproductive health problems are same
among adolescent women who experienced EAM with non experienced women ie:
women who had LAM

14. Relative risk of Reproductive Loss and Morbidity Variable influenced by
Early/Late Marriage for EAG States-NFHS-3 Data
Reproductive Loss
and Morbidity
Variables
BIHAR MADHYA
PRADESH
UTTAR
PRADESH
Rajasthan Chhattisgarh Jharkhand
Terminated
pregnancy
1.305 1.178 1.284 0.787 0.926 0.553
Had any STD in
Last 12 m
1.124 0.411 0.454 1.230 1.190 1.776
Had Genital
Sore in last 12 m
1.965 0.477 1.125 0.407 1.516 1.392
Had Genital
Discharge in Last
12 m
1.314 0.784 0.697 0.904 0.785 0.749

15. Logit Regression:
 To understand the RH factors influencing EAM/LAM
among adolescent women in these EAG states, Logit
regression analysis has been carried out.
Dependent Variable:
Age at marriage : Early <18 years, Late: 18-22 years
Independent Variables: Survival Status, Ever Terminated Preg ,
Reproductive Morbidity

16. Factors influencing Early age at marriage in the EAG State:
Results of Logit Regression Analysis
Variables: Bihar Madhya
Pradesh
Uttar
Pradesh
Rajasthan Chhattisgarh Jharkhand
Exp(B) Exp(B) Exp(B) Exp(B) Exp(B) Exp(B)
Survival Status:
Child Survived (ref)
Child Loss
1.000
1.308
1.000
0.479*
1.000
0.443**
1.000
0.524
1.000
0.516
1.000
0.393
Ever Terminated Preg
No (ref)
Yes
1.000
1.564
1.000
1.536
1.000
1.337
1.000
1.670
1.000
1.368
1.000
1.440
Had any STD in Last 12
months
No (ref)
Yes
1.000
1.138
1.000
2.187*
1.000
3.628*
1.000
0.212
1.000
0.101
1.000
1.129
Had Genital Discharge in Last
12 Months
No (ref)
Yes
1.000
0.554
1.000
0.707
1.000
1.459
1.000
1.237
1.000
1.400
1.000
0.988
-2log likelihood
R Square
496.579
.020
640.791
.033
1342.806
.038
474.795
.026
435.546
.031
427.204
.028

17. Results:
 80 percent adolescent women were married between
14-17 years of age (before the legal age at marriage) in
all EAG states.
 Among the EAG states,83 percent adolescent women
in Bihar and Chattishgarh were married before
reaching 18 years of age.
 Maximum number of adolescent women delivered
with in two years of married life (first birth interval)

18. Contd…
 And nearly 95 percent adolescent women gave two
births with in five years of married life in these EAG
states.
 Around 12 percent of adolescent married had
experienced child loss in these EAG states.
 Reproductive morbidity related to Genital discharge
experienced by 11 to 19 percent of adolescent women in
these EAG states.

19. Results (Contd..)
 Correlation analysis revealed that Number of living
children, First birth interval, total number of children
ever born are negatively significantly related with age
at marriage (early/late) in all these EAG states.
 Adolescent women in Madhya Pradesh, Uttar Pradesh
and Jharkhand experienced child loss more than twice
due to early age at marriage than the adolescent
women with late age at marriage (Relative risk >2).
 Early married adolescent women in Bihar found to be
at high risk for all the three reproductive morbidity
variables.

20. Conclusions:
 From the large survey data analysis it can be concluded
that adolescent women who had married less than 18
years are at risk of reproductive loss in all EAG states .
 States like Bihar, Chhattisgarh and Jharkhand
adolescent women who had early age at marriage are at
high risk with reproductive morbidity.

21. Conclusions…
 Hence it is necessary to improve maternal and health
services in all these EAG states, especially in
Chhattisgarh, Jharkhand and Bihar states.
 To prevent child loss due to early marriage, adolescent
women should be educated through electronic media.
 Family counseling centers should be established in
each Primary Health centre to educate young married
couple to accept family planning methods to increase
the inter birth interval in these EAG states.

22. THANK YOU