Stolen childhood taking a toll at young adulthood: The higher risk of high blood pressure and high blood glucose comorbidity among child brides

Despite notable progress being made in preventing child marriage, a significant proportion of women worldwide are still married before reaching adulthood. Though many aspects of child marriage have been widely studied, little is known on the later life health outcomes of child brides, let alone the critical need for healthcare during adulthood. This paper examines whether child brides at a young adult age bear a greater risk of high blood pressure (HBP) and high blood glucose (HBG) comorbidity than those who were married as adults. Using nationally representative data from India, we categorized married young adult (aged 20-34 years) women in four categories: neither HBP nor HBG, HBP only, HBG only, and both HBP and HBG. We estimated multinomial logistic regressions to obtain unadjusted and adjusted relative risk ratios in favor of these mutually exclusive outcomes for the child marriage indicator. Around 0.5% of the women in our sample had high blood pressure and high blood glucose comorbidity. While the prevalence of comorbidity was 0.4% among women who were married as adults, comorbidity was 40% higher (p < 0.000) among women who were married as children. The relative risk of the comorbidity among child brides was 1.4 (95%CI: 1.2–1.7) times that of their peers who were not married as children. The findings, thus, suggest that child brides at young adult age are at greater risk of having high blood pressure and high blood glucose comorbidity. Concerted public health efforts, therefore, are necessary to improve their long-term health and wellbeing.

[1]  B. Datta,et al.  Adding to her woes: child bride's higher risk of hypertension at young adulthood. , 2022, Journal of public health.

[2]  Z. El-Khatib,et al.  Prevalence and Socioeconomic Factors of Diabetes and High Blood Pressure Among Women in Kenya: A Cross-Sectional Study , 2021, Journal of Epidemiology and Global Health.

[3]  Kriti Vikram Early marriage and health among women at midlife: Evidence from India , 2021, Journal of Marriage and Family.

[4]  B. Datta,et al.  Hypertension in women: the role of adolescent childbearing , 2021, BMC Public Health.

[5]  A. Pakhare,et al.  National noncommunicable disease monitoring survey (NNMS) in India: Estimating risk factor prevalence in adult population , 2021, PloS one.

[6]  Efehan Ulas,et al.  Child marriage and its impact on fertility and fertility-related outcomes in South Asian countries , 2020 .

[7]  A. Agardh,et al.  Desire to delay the first childbirth among young, married women in India: a cross-sectional study based on national survey data , 2020, BMC Public Health.

[8]  Tanusree Mishra,et al.  Child marriage: some facts from selected Indian states , 2020 .

[9]  S. Subramanian,et al.  Socioeconomic Gradients and Distribution of Diabetes, Hypertension, and Obesity in India , 2019, JAMA network open.

[10]  T. Cheng,et al.  Life Course Approaches to the Causes of Health Disparities. , 2019, American journal of public health.

[11]  B. Datta,et al.  Assessing the relationship between out-of-pocket spending on blood pressure and diabetes medication and household catastrophic health expenditure: evidence from Pakistan , 2019, International Journal for Equity in Health.

[12]  B. Datta,et al.  The crowding out effect of out-of-pocket medication expenses of two major non-communicable diseases in Pakistan. , 2018, International health.

[13]  J. Hussey,et al.  Comorbid hypertension and diabetes among U.S. women of reproductive age: Prevalence and disparities. , 2018, Journal of diabetes and its complications.

[14]  Rajeev Gupta,et al.  Emerging trends in hypertension epidemiology in India , 2018, Journal of Human Hypertension.

[15]  Stephen S. Lim,et al.  The increasing burden of diabetes and variations among the states of India: the Global Burden of Disease Study 1990–2016 , 2018, The Lancet. Global health.

[16]  J. Meigs,et al.  Hypertension and Diabetes Mellitus: Coprediction and Time Trajectories , 2018, Hypertension.

[17]  John R. Petrie,et al.  Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms , 2017, The Canadian journal of cardiology.

[18]  Sanjay Jain,et al.  Prevalence and determinants of comorbid diabetes and hypertension: Evidence from non communicable disease risk factor STEPS survey, India. , 2017, Diabetes & metabolic syndrome.

[19]  B. Alvarado,et al.  Adolescent Childbirth Is Associated With Greater Framingham Risk Scores for Cardiovascular Disease Among Participants of the IMIAS (International Mobility in Aging Study) , 2017, Journal of the American Heart Association.

[20]  Ashok Kumar Das,et al.  Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR-INDIAB population-based cross-sectional study. , 2017, The lancet. Diabetes & endocrinology.

[21]  Kristy Iglay,et al.  Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus , 2016, Current medical research and opinion.

[22]  Un Desa Transforming our world : The 2030 Agenda for Sustainable Development , 2016 .

[23]  S. Anderson,et al.  Usual Blood Pressure and Risk of New-Onset Diabetes , 2015, Journal of the American College of Cardiology.

[24]  A. Kes,et al.  Economic Impacts of Child Marriage: A Review of the Literature , 2015 .

[25]  Blum Rw,et al.  Girlhood not motherhood. Preventing adolescent pregnancy. , 2015 .

[26]  D. Xavier,et al.  Prevalence, risk factors and awareness of hypertension in India: a systematic review , 2013, Journal of Human Hypertension.

[27]  L. Appel,et al.  Glycated Hemoglobin and Risk of Hypertension in the Atherosclerosis Risk in Communities Study , 2012, Diabetes Care.

[28]  B. Sen,et al.  Teen Motherhood and Long-Term Health Consequences , 2012, Maternal and Child Health Journal.

[29]  R. Ratner,et al.  Hypertension Complicating Diabetic Pregnancies: Pathophysiology, Management, and Controversies , 2011, Journal of clinical hypertension.

[30]  R. Bretzel,et al.  Comorbidity of diabetes mellitus and hypertension in the clinical setting: A review of prevalence, pathophysiology, and treatment perspectives , 2007 .

[31]  J. Lynch,et al.  A life course approach to chronic disease epidemiology. , 2005, Annual review of public health.

[32]  M. Greene,et al.  Too young to wed. The lives rights and health of young married girls. , 2003 .