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Marriage and pregnancy during adolescence have been associated with an increased risk of preterm delivery. We investigate independent associations of age at marriage and age at first pregnancy with preterm delivery in a cohort of women from rural lowland Nepal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed data from 17 974 women in the Low Birth Weight South Asia Trial. Logistic regression models tested associations of age at marriage and age at first pregnancy with preterm delivery, for primigravida (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u00a06 243) and multigravida (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u00a011 731) women. Models were adjusted for maternal education, maternal caste, and household asset score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety percent of participants had married at &lt;18\u2009years and 58% had their first pregnancy at &lt;18\u2009years. 20% of participants delivered preterm. Primigravida participants married at \u226414\u2009years had higher odds of preterm delivery than those married \u226518\u2009years, when adjusting for study design (adjusted odds ratio (aOR) 1.45, 95% CI: 1.15\u20131.83), confounders (aOR 1.28: 1.01\u20131.62) and confounders\u2009+\u2009age at pregnancy (aOR 1.29: 1.00\u20131.68). Associations were insignificant for multigravida women. No significant associations were observed between age at first pregnancy and preterm delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this population, early marriage, rather than pregnancy, is a risk factor for preterm delivery. We hypothesize that psychological stress, a driver of preterm delivery which is increased among those marrying young, rather than physiological immaturity, drives this association. Further research into the psychological consequences of child marriage in Nepal is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajhb.23709","type":"journal-article","created":{"date-parts":[[2021,12,4]],"date-time":"2021-12-04T06:05:43Z","timestamp":1638597943000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Associations between early marriage and preterm delivery: Evidence from lowland Nepal"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0766-7727","authenticated-orcid":false,"given":"Faith A.","family":"Miller","sequence":"first","affiliation":[{"name":"Institute for Global Health (IGH) University College London (UCL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akanksha A.","family":"Marphatia","sequence":"additional","affiliation":[{"name":"Department of Geography University of Cambridge  Cambridge UK"},{"name":"Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health (ICH) University College London (UCL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0411-8025","authenticated-orcid":false,"given":"Jonathan C.","family":"Wells","sequence":"additional","affiliation":[{"name":"Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health (ICH) University College London (UCL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Cortina\u2010Borja","sequence":"additional","affiliation":[{"name":"Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health (ICH) University College London (UCL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharma S.","family":"Manandhar","sequence":"additional","affiliation":[{"name":"Mother and Infant Research Activities (MIRA)  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-3684","authenticated-orcid":false,"given":"Naomi M.","family":"Saville","sequence":"additional","affiliation":[{"name":"Institute for Global Health (IGH) University College London (UCL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,4]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"62","volume-title":"Towards adulthood: Exploring the sexual and reproductive health of adolescents in South Asia","author":"Adhikari R.","year":"2003"},{"key":"e_1_2_11_3_1","unstructured":"Althabe F. 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