eprintid: 10115405 rev_number: 22 eprint_status: archive userid: 608 dir: disk0/10/11/54/05 datestamp: 2020-11-20 13:41:04 lastmod: 2021-12-20 11:57:54 status_changed: 2020-11-20 13:41:04 type: article metadata_visibility: show creators_name: Marphatia, AA creators_name: Saville, NM creators_name: Manandhar, DS creators_name: Cortina-Borja, M creators_name: Reid, AM creators_name: Wells, JCK title: Independent associations of women's age at marriage and first pregnancy with their height in rural lowland Nepal ispublished: pub divisions: UCL divisions: B02 divisions: D01 divisions: D13 divisions: G25 keywords: adolescent marriage, early pregnancy, height, rural lowland Nepal, social selection note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: OBJECTIVES: In many South Asian communities, the majority of women are married during adolescence and reproduce before 20 years. Early reproduction may adversely affect maternal nutrition and linear growth, however whether early marriage has similar effects is unknown. Shorter women might also be preferentially chosen for earlier marriage. We hypothesized that early marriage and early pregnancy may each be associated with women's shorter height, independent of any selection effects. MATERIALS AND METHODS: We analyzed cross-sectional data on 7,146 women aged 20-30 years from rural lowland Nepal. Linear regression models tested associations of early marriage and early reproduction with height, adjusting for women's education and husbands' characteristics (education and wealth) that might index preferential selection of short young women for marriage. RESULTS: Median ages at marriage and first pregnancy were 15 and 18 years, respectively, with 20% pregnant <16 years. Both early marriage and early pregnancy were independently associated with shorter stature, accounting for a decrement of 1.4 cm, which decreased to 1 cm after adjusting for women's education. Effects of early marriage and reproduction persisted after adjusting for the tendency of poorer and less educated men to marry young and short women, indicating a role for social selection. DISCUSSION: The decrements in height associated with early marriage and reproduction are indicative of broader adverse effects on maternal metabolism during a "critical period" of growth and maturation in the life-course of women. Although the magnitudes of effect are relatively small, they affect large numbers of women in this population. date: 2021-01 date_type: published official_url: http://dx.doi.org/10.1002/ajpa.24168 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1828495 doi: 10.1002/ajpa.24168 lyricists_name: Cortina Borja, Mario lyricists_name: Saville, Naomi lyricists_name: Wells, Jonathan lyricists_id: MCORT36 lyricists_id: NMSAV73 lyricists_id: JWELL04 actors_name: Wells, Jonathan actors_id: JWELL04 actors_role: owner full_text_status: public publication: American Journal of Physical Anthropology volume: 174 number: 1 pagerange: 103-116 event_location: United States citation: Marphatia, AA; Saville, NM; Manandhar, DS; Cortina-Borja, M; Reid, AM; Wells, JCK; (2021) Independent associations of women's age at marriage and first pregnancy with their height in rural lowland Nepal. American Journal of Physical Anthropology , 174 (1) pp. 103-116. 10.1002/ajpa.24168 <https://doi.org/10.1002/ajpa.24168>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10115405/1/AJPA-2020-00214.R1_accepted.pdf