Maternal age at marriage and child nutritional status and development: evidence from Serbian Roma communities

Objective: This study aimed to assess whether maternal age at first marriage is associated with nutritional and developmental penalties in Roma children. Design: Roma nationally representative population-based study. Proxies for child nutritional outcomes included children's individual-level height-for-age Z (HAZ) and weight-for-age Z (WAZ) scores, HAZ and WAZ scores below two standard deviations from the median of WHO's reference population (children aged 0-59 months) and Early Child Development (ECD) (children aged 36-59 months). Multiple and logistic regressions were used to estimate the association between maternal age at marriage and the outcomes and other socio-demographic determinants as possible confounders. Setting: Aggregated data from UNICEF's fifth and sixth Multiple Indicator Cluster Surveys for Serbian Roma settlements. Participants: Children (n 2652) aged 0-59 months born to ever-married women aged 15-48 years. Results: In total, 64 % of women married before age 18, 19 % of children were stunted, 9 % wasted and ECD score was low. Maternal age at first marriage was not associated with either nutritional status or early development of Roma children. Weight at birth (children aged 0-24 years) emerged as the main predictor of children's nutritional status. Boys were more likely to be shorter, more stunted and wasted than girls. Child's age, maternal parity and unimproved toilet facility negatively impacted nutritional status, while maternal literacy mitigated against poor nutritional and developmental outcomes. Conclusions: Roma children up to 5 years of age bear no negative consequences of maternal early marriage. The underlying determinants of children's well-being include improved sanitation, child characteristics, maternal literacy and reproductive behavior and parental investment.