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Updated: Jan 8, 2026

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Early Marriage, Preterm Birth, and School Dropout: An Intergenerational Cycle of Risk?

Jonathan C Wells1, Qisty Noviyanti1, Akanksha A Marphatia1,2

  • 1Childhood Nutrition Research Centre, Population Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, London, UK.

American Journal of Human Biology : the Official Journal of the Human Biology Council
|December 15, 2025
PubMed
Summary

An intergenerational cycle linking early marriage, preterm birth, and school dropout is plausible. Evidence supports early marriage predicting preterm birth and school dropout predicting early marriage, but not preterm birth predicting low educational attainment.

Keywords:
child marriageearly marriageeducationintergenerationalpretermschooling

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Area of Science:

  • Reproductive Health
  • Global Health
  • Sociology

Background:

  • Girls' early marriage is a recurring issue in high-risk populations.
  • The interplay between behavior and biology in this context is poorly understood.
  • An intergenerational cycle of risk involving early marriage, preterm birth, and school dropout is hypothesized.

Purpose of the Study:

  • To evaluate evidence for an intergenerational cycle of risk linking early marriage, preterm birth, and school dropout.
  • To test specific hypotheses regarding the associations between these factors in low- and middle-income countries.

Main Methods:

  • Systematized review of articles published from 2000 to 2025.
  • Testing four hypotheses: early marriage-preterm birth, preterm birth-low educational attainment, school dropout-early marriage, and preterm birth-cognitive function.
  • Inclusion of empirical articles and systematic reviews, with assessment of risk of bias.

Main Results:

  • Evidence supports the association between early marriage and preterm birth (H1).
  • Evidence supports the association between school dropout and early marriage (H3), though directions varied.
  • Evidence for preterm birth predicting low educational attainment (H2) was weak.
  • Systematic reviews supported preterm birth being associated with reduced cognitive function (H4).
  • Most empirical studies had a low risk of bias.

Conclusions:

  • An intergenerational cycle linking early marriage, preterm delivery, and low educational attainment is plausible.
  • This cycle involves behavioral pathways (school dropout, early marriage) and biological mechanisms (preterm birth, cognitive function).
  • Further research is needed on prospective associations between preterm birth and school outcomes, and school dropout and early marriage in low- and middle-income countries.