Keeping teens in school after marriage can delay their pregnancy: a time-to-event analysis from National Family Health Survey 5, India

Teenage marriage and subsequent early pregnancies remain critical issues in many developing regions, particularly India, where socio-cultural norms and economic disadvantages perpetuate these practices. Early pregnancies following teenage marriages significantly affect maternal and child health, educational attainment, and economic opportunities, ultimately reinforcing cycles of poverty and gender inequity. While various interventions aim to delay marriage, there is limited evidence on strategies to delay pregnancy in already-married adolescents. This study examines factors influencing the time interval between teenage marriage and first pregnancy in a nationally representative sample of young Indian women. Data from the National Family Health Survey-5 (NFHS-5) were analysed, focusing on 44,921 women who were aged 20–24 years at the time of survey, but who were married in their teens. was carried out where first pregnancy (live birth or termination or conception) was the event and the interval between marriage and event was the time variable. Socio-economic factors included wealth, caste, rural/urban residence and three dimensions of education. Among women who were married in their teens, 91.13% experienced pregnancy by the time of their interview, with a median interval of 2 years between marriage and first pregnancy event. Socio-economic factors like wealth, education, and caste showed minimal protective effects, but notably those teens continuing education post-marriage delayed their first pregnancy by 35%; minimally adjusted (ETR):1.18(95% confidence interval:1.15, 1.21); fully adjusted ETR: 1.35(1.29,1.41). Once women get married in their teens, cultural norms promoting early procreation often neutralise the effect of classic socio-economic factors that normally delay pregnancies, leading to early childbirth. But only those continuing education after teenage marriage carried significant less risk of early pregnancy, highlighting the need for policies enabling continuation of education or re-entry into the education system of married teens. A multi-sectoral approach involving education, health, and social welfare systems is crucial to keep married adolescents in the education system.