Gender disparities in the association between age at first marriage and chronic diseases: evidence from the Azar...

The role of age at first marriage in chronic disease risk remains understudied, and evidence on its association with chronic health outcomes in men and women is limited. We therefore examined the relationship between age at first marriage and the risk of chronic diseases among adult men and women in the Azar cohort.

This cross-sectional study used data from 13,326 participants in the Azar Cohort, which evaluates risk factors for chronic non-communicable diseases (NCDs) in northwest Iran. A structured questionnaire captured demographic variables, age at first marriage, medical history, and personal habits. Based on age at first marriage, participants were classified into two groups: under 18 years (child marriage) and 18 years or older (adult marriage).

Among 13,326 participants, the prevalence of child marriage was 26.36%. Women constituted a larger share of the child marriage group than men (46.6% vs. 3.6%; P < 0.001). In men, child marriage showed no association with NCDs except for obesity (Odds ratio [OR]: 1.43) and multimorbidity (MM) (OR: 1.41). In women, marriage before 18 years was associated with higher odds of diabetes (OR: 1.25), hypertension (OR: 1.37), cardiovascular disease (OR: 1.67), stroke (OR: 1.84), depression (OR: 1.35), obesity (OR: 1.50), and MM (OR: 1.53). Notably, the highest odds occurred for stroke.

Child marriage was associated with obesity and MM in men, and with diabetes, hypertension, cardiovascular disease, stroke, depression, obesity, and depression in women. These results indicate a need for tailored health interventions for people affected by child marriage, particularly women. Longitudinal follow-up is recommended to assess causality.