Having kids early and fast major cause of infant mortality in India, Nepal

Researchers have revealed that having children early and in rapid succession are major factors fueling high infant mortality rates in the South Asian countries of Bangladesh, India, Nepal and Pakistan, where one in 14 births to young mothers ends with the death of the child within the first year.

Anita Raj, PhD, professor of medicine and director of the Center on Gender Equity and Health at University of California, San Diego, and colleagues said younger maternal age (under 18 years old) and short intervals between pregnancies (under 24 months) accounted for roughly one-quarter of the infant mortality rate among young mothers in India and Pakistan, a percentage that represents almost 200,000 infant deaths in 2012 for those two nations alone.

In Bangladesh, only the short inter-pregnancy interval was linked to infant mortality while in Nepal, only young motherhood was associated with infant death.

Infant mortality is a significant public health issue in South Asia.

According to United Nations data, the infant mortality rate worldwide is 49.4 deaths per 1,000 live births. In Pakistan, it is 70.90; India, 52.91; Bangladesh, 48.98 and Nepal, 38.71. By comparison, the infant mortality rate in the United States is 6.81 and just 1.92 in Singapore, lowest in the world.

The new infant mortality findings are based upon analyses of national demographic and health surveys taken in the four countries.

Raj noted the comparisons may be somewhat skewed by imperfect comparisons.

She said that the findings still underscore concerns about the social consequences of child marriage and young motherhood.

In a study published last year, she and colleagues reported that more than 10 million girls under the age of 19 marry each year worldwide, usually under the force of local tradition and social custom. Almost half of these compulsory marriages occur in South Asia.

The findings are published online in the International Journal of Gynecology and Obstetrics.