Child marriage in rural Bangladesh and impact on obstetric complications and perinatal death: Findings from a health and demographic surveillance system
Summary & Objectives
This paper assesses how child marriage continues to shape adolescent pregnancy and adverse birth outcomes in rural Bangladesh. Using a health and demographic surveillance system in Baliakandi, the authors combine historical marriage data (1990–2019) with prospectively identified marriages and pregnancies (2017–2019) to describe trends in child marriage and estimate how maternal age relates to time to first pregnancy, obstetric complications during labour and delivery, and perinatal death
Findings
Child marriage declined over time but remained the majority pattern in 2019. In 1990, 71% of marriages were to girls under 18, and this fell to 53% by 2019; the largest reduction was among very young girls, while marriages at ages 16-17 increased over time. Half of newly married females became pregnant within one year of marriage, including adolescent brides. Adolescent pregnancies were more likely than adult pregnancies to involve self-reported obstetric complications, and adolescents also experienced higher odds of perinatal death, with elevated stillbirth risk among those aged 13–15 and elevated early neonatal death among those aged 16–17 compared with adults. The study also highlights poverty as a reinforcing factor, linking economic vulnerability to both early marriage and adverse perinatal outcomes.
Recommendations
The results support faster, wider implementation of proven prevention approaches rather than incremental progress. The discussion points to interventions shown in Bangladesh to reduce child marriage, including education support, gender rights awareness, and livelihood training, and argues that eliminating child marriage will protect two groups of children at once: adolescent girls and their infants. Programmatically, the findings imply a need to prevent early marriage and to reduce immediate progression to adolescent pregnancy after marriage, while strengthening maternal and newborn care for adolescent mothers to lower obstetric complications and perinatal mortality.
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