Early childhood nutrition, education and fertility milestones in Guatemala

Data on fertility milestones were collected in 1994 and linked to informati on collected in a trial conducted in eastern Guatemala between 1969 and 197 7, to examine whether early childhood nutrition was associated with the tim ing of fertility milestones. In the original trial, two pairs of villages w ere randomly allocated to receive either a high energy,high protein supplem ent (Atole) or a low energy, no-protein supplement (Fresco). Mean age at fo llow-up was 23.47 y (n = 240). About 62% of women had experienced first bir th (median age at:first birth = 19.83 y). The median intervals from menarch e to first intercourse and from first intercourse to first birth were 5.67 and 0.95 y; they were 1.68 and 0.06 y shorter, respectively, for the Atole group than for the Fresco group. Women who had received Atole in utero and/ or during early childhood experienced earlier milestones even after adjusti ng for socioeconomic status (SES), education and age at the prior event. Me dian age at first birth was 1.17 y earlier for the Atole group. Better grow th during early childhood (not severely stunted) led to earlier milestones (median age at first birth was 1.04 y earlier), primarily among women with illiterate fathers. Completion of primary school significantly delayed fert ility milestones; the median age at first birth was 4.27 y later for those who completed primary school compared with those who did not (P < 0.05). In sum, improved nutrition during early childhood results in earlier fertilit y milestones, but the effects of schooling in delaying fertility milestones are greater in magnitude. intervention programs that improve early childho od nutrition should be accompanied by investments in education that ensure that girls complete primary school.