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Relationship between early-life nutrition and ages at menarche and first pregnancy, and childbirth rates of young adults: Evidence from APCAPS in India.

Authors
  • Nandi, Arindam1
  • Behrman, Jere R2
  • Black, Maureen M3, 4
  • Kinra, Sanjay5
  • Laxminarayan, Ramanan6, 7
  • 1 Center for Disease Dynamics, Economics & Policy, Washington, DC, Washington, District of Columbia.
  • 2 Departments of Economics and Sociology, Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania.
  • 3 RTI International, Research Triangle Park, North Carolina.
  • 4 Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland.
  • 5 Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
  • 6 Center for Disease Dynamics, Economics & Policy, New Delhi, New Delhi, India. , (India)
  • 7 Princeton Environmental Institute, Princeton University, Princeton, New Jersey. , (Jersey)
Type
Published Article
Journal
Maternal & child nutrition
Publication Date
Jan 01, 2020
Volume
16
Issue
1
Identifiers
DOI: 10.1111/mcn.12854
PMID: 31141837
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

India's Integrated Child Development Services (ICDS) provides daily supplementary nutrition and other public health services to women and children. We estimated associations between exposure to early-childhood ICDS nutrition and adult reproductive outcomes. During 1987-1990, a balanced protein-calorie supplement called "upma"-made from locally available corn-soya ingredients-was rolled out by subdistricts near Hyderabad and offered to pregnant women and children under age 6 years. In a controlled trial, 15 villages received the supplement and 14 did not. We used data from a 2010-2012 resurvey of adults born during the trial (n = 715 in intervention and n = 645 in control arms). We used propensity score matching methods to estimate the associations between birth in an intervention village and menarcheal age, age at first pregnancy, and fertility of adults. We found that women born in the intervention group during the trial, as compared with the control group, had menarche 0.45 (95% confidence interval [CI: 0.22, 0.68]; p < .001) years later and first pregnancy 0.53 (95% CI [0.04, 1.02]; p < .05) years later. Married women from the intervention group had menarche 0.36 (95% CI [0.09, 0.64]; p < .01) years later, first cohabitation with partner 0.8 (95% CI [0.27, 1.33]; p < .01) years later, and first pregnancy 0.53 (95% CI [0.04, 1.02]; p < .05) years later than married women in the control group. There was no significant difference between intervention and control group women regarding whether they had at least one childbirth or the total number of children born. The findings were similar when we employed inverse propensity score weighted regression models. © 2019 The Authors Maternal & Child Nutrition Published by John Wiley & Sons, Ltd.

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