Notwithstanding the significant improvements
in child survival in recent decades [1], India
accounts for the largest share of the global
burden of under-five mortality with an
estimated 1.2-5.9 million child deaths [2]. Consequently,
scientific efforts continue to identify factors and
interventions that can help improve child survival [3]. An
overwhelming majority of studies are informed, almost
exclusively, by a ‘maternal perspective’, such that
factors and interventions have largely focused on
mothers [3,4]. For instance, increasing educational
attainment among women has been identified and
targeted as a means to achieve rapid progress towards
fourth millennium development goal (MDG-4) [4].
Other maternal specific interventions that have received
considerable attention in the literature include family
planning and care targeted to mothers in the preconception
period along with micronutrient and folic
acid supplementation and early initiation of
breastfeeding during pregnancy and in the postnatal
period [5]. In this issue, Sinha, et al. [6] consider
maternal age at childbirth (hereafter referred to as
maternal age) as a potentially modifiable social
determinant of child survival within a large
prospectively followed cohort. They report that young
motherhood is associated with an increase in child
mortality, leading to a conclusion that delaying age at
pregnancy would confer important survival benefits in
this population.