ObjectiveChild marriage forces a girl into adult roles before physical and psychological maturity, which can take a toll on women's health over the life course. This article aims to assess whether child marriage and adolescent childbearing are associated with elevated risk of gynaecologic disorders leading to hysterectomy.DesignCross‐sectional and time‐to‐event analysis.SettingIndia.Population528 816 ever‐married women, aged 20–49 years.MethodsWomen were grouped in four mutually exclusive categories: (i) married adult—not an adolescent mother (reference category), (ii) married adult—adolescent mother, (iii) married child—not an adolescent mother and (iv) married child—adolescent mother. Multivariable logistic regressions were fitted to assess the odds of hysterectomy for these groups. Nonparametric Kaplan–Meier survivor functions were estimated to evaluate survival rates across the groups.Main Outcome MeasuresWhether had a hysterectomy and age when hysterectomy was performed.ResultsCompared to women married as adults, not an adolescent mother, women married in childhood and gave birth in adolescence were 1.87 (95% CI: 1.78–1.96) times more likely to have a hysterectomy. The latter group also had the lowest survival probability for hysterectomy at all ages (e.g., 85.80% [95% CI: 85.41–86.18] at age 49 years as compared to 91.65% [95% CI: 91.37–91.89] for the former group). Women married as children but not adolescent mothers and married as an adult but gave birth in adolescence also had higher odds of hysterectomy—1.40 (95% CI: 1.31–1.50) and 1.53 (95% CI: 1.40–1.66) times of that of the reference group, respectively.ConclusionsOur results, showing a strong relationship between child marriage and hysterectomy, contribute to the literature on later‐life health consequences of child marriage.

中文翻译：

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印度已婚妇女童婚和青少年生育对子宫切除术的影响：横断面和事件发生时间分析


目的童婚迫使女孩在身心成熟之前就进入成人角色，这可能对妇女一生的健康造成损害。本文旨在评估童婚和青少年生育是否与导致子宫切除术的妇科疾病风险升高相关。设计横断面和事件发生时间分析。背景印度。人口528 816 名已婚女性，年龄 20-49 岁。方法女性分为四个相互排斥的类别：(i) 已婚成人——非青春期母亲（参考类别），(ii) 已婚成人——青春期母亲，(iii) 已婚儿童——非青春期母亲，(iv) 已婚儿童——青春期母亲。拟合多变量逻辑回归来评估这些组进行子宫切除术的几率。对非参数 Kaplan-Meier 幸存者函数进行估计，以评估各组的生存率。主要结果指标是否进行了子宫切除术以及进行子宫切除术时的年龄。结果与成年结婚的女性（而非青春期母亲）相比，在童年时期结婚并在青春期生育的女性进行子宫切除术的可能性高出 1.87 倍（95% CI：1.78-1.96）。后一组在所有年龄段的子宫切除术生存概率也最低（例如，49 岁时为 85.80% [95% CI: 85.41–86.18]，而前一组为 91.65% [95% CI: 91.37–91.89]） ）。童年时结婚但未成为青少年母亲的女性以及成年后结婚但在青春期生育的女性接受子宫切除术的几率也较高，分别为 1.40 (95% CI: 1.31–1.50) 和 1.53 (95% CI: 1.40–1.66) 倍。分别为参考组。结论我们的研究结果显示童婚与子宫切除术之间存在密切关系，为有关童婚对晚年健康影响的文献做出了贡献。