Associations of marital quality and sexual satisfaction in women with early marriage in Iran: a descriptive-correlational study

doi:10.21203/rs.3.rs-3143602/v1

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Associations of marital quality and sexual satisfaction in women with early marriage in Iran: a descriptive-correlational study

https://doi.org/10.21203/rs.3.rs-3143602/v1

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Background

Child marriage occurs partly in most regions of the world and has long been a public health concern all over the world. The current study has been designed to investigate the associations of sexual satisfaction and marital quality in women with early marriage

Methods

This descriptive-correlational study was done on 70 married women under 18–20 years. Sampling was non-random, and the sampling method was stratified multistage. The data collection tools included questionnaires on women's demographic-fertility characteristics, marital quality, sexual satisfaction, sexual self-efficacy and social support. A significance level of P < 0.05 was set for the analysis.

Results

The results of the study showed that individuals with very good sexual satisfaction and high sexual self-efficacy had a non-distress marital quality (p = < 0.001). Based on Pearson’s correlation coefficient, sexual self-efficacy, and social support were significantly and positively correlated with marital quality (r = 0.73, p < 0.001 and r = 0.55, p < 0.001, respectively), and sexual satisfaction was significantly and negatively correlated with marital quality (r=-0.65, p < 0.001).

Conclusion

The findings of the present study showed that women with early marriage, high marital quality does not always ensure their favorable sexual satisfaction. Moreover, high sexual self-efficacy and social support cause favorable marital quality.

Marital Quality

Sexual Satisfaction

Social Support

Early Marriage

One of the objectives of sustainable development is to eliminate all detrimental actions such as child marriages, early marriages, and forced marriages by 2030 [1]. Child marriage is defined as getting married before 18 years of age [2]. Twelve million girls under 18 years of age get married annually worldwide [3]. Child marriage is a violation of human rights because it may deprive someone of many opportunities, such as education, health, and safety [4]. The age of the first marriage significantly affects women’s empowerment [5]. Child marriage occurs partly in most regions of the world and has long been a public health concern all over the world because it has the potential to deprive female adolescents of their sexual reproductive health rights and limit their ability to achieve their full potential in life [6, 7]. Child marriage is still a common activity associated with poor physical and mental health and also socioeconomic status [8]. There is a positive correlation between rural poverty and child marriage, showing that regions with higher poverty may accompany a higher occurrence of child marriage [9]. The results of a study indicate that the illiteracy of each of the partners and belonging to a poor family increase the risk of early marriage [10]. The results of another study show that education is the most significant variable in predicting the likelihood of early marriage, and the variables of type of marriage [forced or optional], family relationship with spouse, and place of residence are other predictive variables [11]. The adverse effects of child marriage are not only experienced at the individual level but are also observed during generations, as the children of girls who get married in childhood often suffer from health deficits and malnutrition [12]. Gender inequality remains a common global concern and has been recognized as a crucial factor in the occurrence of child marriage. Moreover, education may be an influential strategy to reduce child marriage [9].

Sexual health is an essential aspect of adolescents’ overall health and quality of life. Sexual health includes psychosocial, physical, developmental, and emotional factors affecting sexual functioning [13]. Numerous factors predict early sexual onset, so low life satisfaction, and happiness are associated with early sexual onset. Early onset of sexual activity is associated with an increased risk of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) development and other sexually transmitted diseases among adolescents, having multiple sexual partners, not using contraceptive methods, unintended pregnancy, illegal abortion [14]. On the other hand, a large number of conflicts in marital relations are due to the incompatibility of couples in terms of individual and cultural characteristics, including age compatibility. Since the husbands of girls getting married at a young age are mostly old men who have previously had sexual partners, the percentage of developing sexually transmitted diseases is higher among such children [15]. Physical, mental, and social competence and preparation are necessary for married life. With various justifications, unfortunately, early marriages occur that often involve annoyance, exploitation, violence against children, and serious conflicts with their rights [16]. Sexual satisfaction is one of the most significant factors in ensuring married life satisfaction, and it is one of the most important factors affecting the couples’ health and quality of life. Sexual satisfaction refers to an individual’s feelings in a sexual relationship. Therefore, in families with no satisfactory sexual activity, all types of sexual problems occur [17]. Social norms of early marriage, the financial burden of school tuition, and the minimal opportunity for girls in education are among the consequences of child marriage. However, with the support of parents and teachers, some girls can continue their education and delay marriage. Unfortunately, girls who get married early are less supported by the family and programs available to continue their education, and efforts should be made for educational support for girls who are married and have children [18]. Besides receiving the husband’s support for a woman, another source of support may also exist [19]. Thus, considering the importance of early marriage in women, the current study has been designed to investigate the associations of sexual satisfaction and marital quality in women with early marriage in the city of Sepiddasht in Iran.

This research is a descriptive-correlational study conducted from 12 September 2022 to 5 June 2023 after the approval of the Ethics Committee of Babol University of Medical Sciences (code of ethics: IR.MUBABOL.REC.1401.148) and Lorestan University of Medical Sciences to investigate 70 married women under 18–20 years of age referring to the health centers of the city of Sepiddasht in Lorestan University of Medical Sciences who were willing to participate in the study. Based on the following formula with a confidence level of 95% and a test power of 90%, the minimum sample size was estimated at 38 people, and since the sampling method was cluster sampling, the sample size was estimated at 65 people by considering the effect size of 1.7, which with a 15% possibility of drop, it was finally estimated to be 75 people [20].

The standard normal deviate for α = Zα = 1.9600

The standard normal deviate for β = Zβ = 1.2816

C = 0.5 * ln[(1 + r)/(1-r)] = 0.5493

This research is a descriptive-correlational study conducted from 12 September 2022 to 5 June 2023 after the approval of the Ethics Committee of Babol University of Medical Sciences (code of ethics: IR.MUBABOL.REC.2022.148) and Lorestan University of Medical Sciences to investigate 70 married women under 18–20 years of age referring to the health centers of the city of Sepiddasht in Lorestan University of Medical Sciences who were willing to participate in the study. Based on the following formula with a confidence level of 95% and a test power of 90%, the minimum sample size was estimated at 38 people, and since the sampling method was cluster sampling, the sample size was estimated at 65 people by considering the effect size of 1.7, which with a 15% possibility of drop, it was finally estimated to be 75 people [20].

Measurements

The data collection tools included questionnaires on women's demographic-fertility characteristics, marital quality, sexual satisfaction, sexual self-efficacy and social support.

Demographic-fertility Characteristics questionnaire used in this study covers various aspects, including age, husband's age, menarche age, marriage age, duration of marriage, education, husband's education, BMI (Body mass index), husband' BMI, occupation, husband' occupation, residence, satisfaction with income, interval age of couple, headed status, smoking, marriage of satisfaction, number of intercourse, type of pregnancy, number of abortion, number of children and reproductive status.

Quality of Marriage Index (QMI) is a credible, valid, and global measure formulated by Norton because the mean correlation of the total items was 0.76 during the instrument development. This instrument is a six-question self-report questionnaire that measures marital quality using general phrases such as (we have a good marriage). The subject expresses his/her level of agreement in five questions of the questionnaire ranging from 1 (completely disagree) to 7 (completely agree). In the sixth question, which is a general question, the subject expresses his/her level of agreement in a range from 1 (completely disagree) to 10 (completely agree). The QMI score can range from 6 to 45, where higher scores denote greater marital satisfaction [21]. A score of ≤ 29 states relationship distress [22].

Fincham et al. reported the reliability of this questionnaire using Cronbach’s alpha of 0.96 for both male and female groups [23]. In Maroufizadeh et al.’s study, the internal consistency of this scale was calculated using Cronbach’s alpha of 0.92 [24].

Hudson’s Index of Sexual Satisfaction (ISS) was used to assess sexual satisfaction. This index is a 25-question instrument to measure the degree, intensity, or range of marital problems between couples. This scale has sufficient internal consistency (a = 0.92) and a reliability coefficient (0.76). This scale is considered a self-report questionnaire, including “I think our sexual relationships are wonderful” and “Our sexual relationships are monotonous”, rating 1 [never] to 7 (always) and ranging from 25 to 175. Higher scores indicate higher sexual satisfaction [25]. Also, in a study, the alpha coefficient for couples was higher than 0.90 [17].

In a study in Iran, the reliability coefficient of this index was calculated using Cronbach’s alpha equal to 0.97 [26]. In our study, scores < 70 were considered without sexual satisfaction, with mild sexual satisfaction, or with moderate sexual satisfaction, and scores ≥ 70 were considered high sexual satisfaction.

Sexual Self-Efficacy Questionnaire is a scale based on Schwarzer’s General Self-Efficacy Questionnaire [27], designed by Vaziri and Lotfi Kashani. This questionnaire consists of 10 multiple-choice questions scored from 0 [not at all correct] to 3 [completely correct]. The reliability of this questionnaire has been reported as 0.86 using Cronbach’s alpha, 0.81 using Spearman-Brown bisection, and 0.81 using Guttman’s method. The reliability of this questionnaire has been confirmed in Iran using content validity. The minimum and maximum possible scores are 0 and 30, respectively. Higher scores denote better sexual self-efficacy [28]. In our study, scores < 15 were considered low sexual self-efficacy, and scores ≥ 15 were considered high sexual self-efficacy.

Social Support Questionnaire (SSQ) was developed by Fleming et al. with 25 questions regarding receiving support from friends and relatives [3 questions], neighbors [4 questions], family [7 questions], society [6 questions], and ideas about social support [5 questions]. For each question, a score of 1 is considered for the positive answer, a score of 0 is considered for the negative answer, and the total score is 0–25 [29]. In a study on Iranian society, it was calculated with a Cronbach’s alpha of 0.72 [30].

Statistical analysis

SPSS software (version 20) and descriptive statistics indices (mean, standard deviation, frequency distribution table, and relative frequency) were used for data analysis, and Pearson’s correlation coefficient test was used to determine the two-way relationship (correlation).

Of the women participating in the study, five migrated to other cities, and the analysis was performed on 70. The mean age of women was 18.9 (0.7) years, and their mean age of marriage was 15.2 (2.1) years. The majority of them had an education level of 6–11 years, were housewives 61 (87.1), and lived in villages 57 (81.4). Women were significantly different in the two groups of marital quality in terms of husband’s age (p = 0.012), menarche age (p = 0.006), education (p = 0.039), husband’s education (p = 0.025), husband’s occupation (p = 0.004), satisfaction of income (p = 0.041), head status (p = 0.045), and smoking (p = 0.058) (Table 1). The fertility status of women is shown in Table 2. As seen in the table, the majority of women had 1–2 children 33 (47.1), their intercourse times were less than four times a week 40 (57.1), and they were satisfied with their marriage 33 (47.1) (Table 2).

Table 1

Characteristic of women with early marriage according to marital quality (n = 70)
Variables	Total f (%)	Relationship distress (n = 33) f (%)	No relationship distress (n = 37) f (%)	P-value^†
Age (years), mean (SD)	18.9 (0.7)	18.8 (0.6)	18.9 (0.7)	0.385
Husband's age (years), mean (SD)	26.0 (5.1)	24.4 (3.7)	27.4 (5.8)	0.012
Marriage age (years), mean (SD)	15.2 (2.1)	15.5 (1.1)	15.0 (2.6)	0.301
Menarche age (years)				0.006
< 13	48 (68.6)	28 (84.8)	20 (54.1)
≥ 13	22 (31.4)	5 (15.2)	17 (45.9)
Duration of marriage (years)				0.832
2–3	33 (47.1)	16 (48.5)	17 (45.9)
4–5	37 (52.9)	17 (51.5)	20 (54.1)
Education (years)				0.039
< 6	27 (38.6)	17 (51.5)	10 (27.0)
6–11	29 (41.4)	13 (39.4)	16 (43.2)
≥ 12	14 (20)	3 (9.1)	11 (29.7)
Husband's education (years)				0.025
< 6	20 (28.6)	11 (33.3)	9 (24.3)
6–11	26 (37.1)	16 (48.5)	10 (27.0)
≥ 12	24 (34.3)	6 (18.2)	18 (48.6)
BMI^* (kg/m² )				0.394
< 25	58 (82.9)	26 (78.8)	32 (86.5)
≥ 25	12 (17.1)	7 (21.2)	5 (13.5)
Husband' BMI^* (kg/m2 )				0.592
< 25	59(84.3)	27 (81.8)	32 (86.5)
≥ 25	11 (15.7)	6 (18.2)	5 (13.5)
Occupation				0.588
House wife	61 (87.1)	28 (84.8)	33 (89.2)
Worker	9 (12.9)	5 (15.2)	4 (10.8)
Husband' occupation				0.004
Employee	3 (4.3)	0.0 (0.0)	3 (8.1)
Worker	41(58.6)	26 (78.8)	15 (40.5)
Farmer	26 (37.1)	7 (21.2)	19 (51.4)
Residence				0.487
Village	57 (81.4)	28 (84.8)	29 (78.4)
City	13 (1.6)	5 (15.2)	8 (21.6)
Satisfaction of income				0.041
Satisfied	19 (27.1)	6 (18.2)	13 (35.1)
Relatively satisfied	31 (44.3)	13 (39.4)	18 (48.6)
Unhappy	20 (28.6)	14 (42.4)	6 (16.2)
Interval age of couple (years)				0.266
< 5	18 (25.7)	11 (33.3)	7 (18.9)
5–10	42 (60.0)	19 (57.6)	23 (62.2)
> 10	10 (14.3)	3 (9.1)	7 (18.9)
Headed status				0.045
Female-headed household	2 (2.9)	2 (6.1)	0.0 (0.0)
Husband- headed household	57 (81.4)	23 (69.7)	34 (91.9)
Family husband-headed household	11 (15.7)	8 (24.2)	3 (8.1)
Smoking				0.058
Usage history/no current use	20 (28.5)	5 (15.2)	15 (40.5)
Exposed to	40 (57.1)	23 (69.7)	17 (45.9)
Current smoker	10 (14.3)	5 (15.2)	5 (13.5)
^* BMI: Body mass index
^†The data were assessed using chi-square and t-tests

Table 2

Fertility status of women with early marriage (n = 70)
Variables	f (%)
Marriage of satisfaction
Satisfied	33 (47.1)
Relatively satisfied	30 (42.9)
Unhappy	7 (10.0)
Number of intercourse (in week)
< 4	40 (57.1)
≥ 4	30 (42.9)
Pregnancy (number)
Wanted pregnancy	44 (62.9)
Unwanted pregnancy	15 (21.4)
Abortion (number)
Induced abortion	10 (14.3)
Spontaneous abortion	9 (12.9)
Children (number)
0	29 (41.4)
1–2	33 (47.1)
≥ 3	8 (11.4)
Still birth	2 (2.9)
Reproductive status
Breastfeeding	19 (27.1)
Pregnant	2 (2.9)
Non-pregnant	49 (70.0)
Pregnancy intention	20 (28.6)
Non-use of contraceptive method	23 (32.9)

The status of sexual satisfaction, sexual self-efficacy, social support, and marital quality are reported in Table 3. The mean marital quality of most women was 37 (52.9), who were placed in the “no relationship distress” group. Their mean sexual self-efficacy was mostly 46 (55.7), which had high sexual self-efficacy. Also, the most social support was in the family subscale (Table 3). The associations of sexual satisfaction and sexual self-efficacy with marital quality are represented in Table 4. There was a significant association between sexual satisfaction and marital quality, and individuals with very good sexual satisfaction had a non-distress marital quality (p = < 0.001). Individuals with high sexual self-efficacy also had a non-distress marital quality (p = < 0.001) Table 4. The association between social support and marital quality in women is reported in Table 5. Women in the two groups had significant differences in marital quality in the two subscales of family support (p = < 0.001) and neighbor support (p = 0.006) (Table 5). Based on Pearson’s correlation coefficient, sexual self-efficacy, and social support were significantly and positively correlated with marital quality (r = 0.73, p < 0.001 and r = 0.55, p < 0.001, respectively), and sexual satisfaction was significantly and negatively correlated with marital quality (r=-0.65, p < 0.001) (Table 6).

Table 3

Status of sexual satisfaction, sexual self – efficacy, social support, and quality of marriage in women with early marriage (n = 70)
Variables	mean (SD)
ISS*
no/mild/moderate < 70	52 (74.3)
Sever ≥ 70	18 (25.7)
Sexual self – efficacy
Low Sexual self – efficacy < 15	24 (34.3)
High Sexual self – efficacy ≥ 15	46 (55.7)
Social support
Friends	1.7 (1.2)
Neighbors	2.5 (1.4)
Family	5.2 (2.1)
Public	2.7 (1.6)
Belief about the support	3.3 (0.8)
QMI**
Relationship distress	33 (47.1)
No relationship distress	37 (52.9)
*ISS: Index of sexual satisfaction
**QMI: Quality of marriage index

Table 4

Association sexual satisfaction and sexual self – efficacy with marital quality in women with early marriage (n = 70)
Variables	Relationship distress (n = 33) mean (SD)	No relationship distress (n = 37) mean (SD)	P-value^†
ISS^*			< 0.001
no/mild/moderate < 70	16 (48.5)	36 (97.3)
Sever > = 70	17 (51.5)	1 (2.7)
Sexual self – efficacy			< 0.001
Low Sexual self – efficacy < 15	22 (66.7)	2 (5.4)
High Sexual self – efficacy ≥ 15	11 (33.3)	35 (94.6)
*ISS: Index of sexual satisfaction
†The data were assessed using t- test

Table 5 Association Social support with marital quality in women with early marriage (n = 70)

Variables	Relationship distress (n=33) mean (SD)	No relationship distress (n=37) mean (SD)	P-value^†
Social support
Friends	1.5 (1.3)	1.9 (1.2)	0.187
Neighbors	2.0 (1.5)	3.0 (1.1)	0.006
Family	4.0 (2.4)	6.1 (1.3)	<0.001
Public	2.5 (1.7)	2.8 (1.6)	0.516
Belief about the support	3.1 (0.8)	3.4 (0.8)	0.151

†The data were assessed using t- test

Table 6

Correlation between sexual satisfaction, sexual self – efficacy, and social support with marital quality in women with early marriage (n = 70)
Variables	r^*	P-value^†
ISS*	-0.65	< 0.001
Sexual self – efficacy	0.73	< 0.001
Social Support	0.55	< 0.001
*ISS: Index of sexual satisfaction
†The data was assessed using Pearson Correlation
*Correlation is significant at the P-value < 0.01

The results of this study indicated that the mean marital quality of most women 37 [52.9] was in the “no relationship distress” range. Consistent with our study, the results of McNulty et al.’s research indicated that women with early marriage reported relatively low marital quality [17]. The results of a study also showed that women with late marriage had a higher marital adjustment, while those with early marriages showed more psychological problems [31]. In another study, marital quality was examined at two-time points: Five months and two years after the early marriage; the results indicated that husbands’ permanent use of suppressing wives was the strongest predictor of lower marital quality over time [32]. On the other hand, women with early marriages experience various types of marital and family disturbances, such as divorce, separation, and marital abuse [5]. The above materials suggest that women’s early marriage culminates in low marital quality in them, and low marital quality leads to problems in the interaction of these women with various issues in life. Therefore, solutions should be considered to prevent early marriage.

In this study, women whose husband’s age was higher, their menarche age was under 13 years old, their own education was less than 6 years, their husband’s education was 6–11 years, and their husband’s occupation was labor were unsatisfied of their income, their husband was the household head and were exposed to cigarette smoke, their marital quality was in the “relationship distress” group. The results of a study suggested that low-income couples did not have more satisfying marriages, and efforts should be made to support the marriages of low-income couples [33]. Abera et al. reported that women with early marriages were more likely to get married to older men and drop out of school soon [5].

The results of this study indicated that the majority of women had no sexual satisfaction or they had mild or moderate sexual satisfaction. The results of a study consistent with our study indicated that marital satisfaction among students with early marriages was moderate[34]. Another study reported that with early marriage in the golden years of life, young women would become victims of violence, causing the most damage [35]. Chauhan et al.’s study in India showed that men belonging to high-income families were more satisfied with their marriages. Also, the education level of fathers, mothers, and married men was another crucial determinant of marital satisfaction [36]. Thus, family education is considered a strong predictor of marital satisfaction, and policymakers should pay special attention to this aspect.

Based on the results of our study, women in the “relationship distress” group had low sexual self-efficacy, and those in the “no relationship distress” group had high sexual self-efficacy. The results of Packer et al.’s study in rural areas of Mozambique indicated that poverty, early marriage, and childbearing were among the main obstacles to female adolescents’ progress, and self-efficacy helped them achieve their goals [37]. Assarzadeh et al. suggested that sexual self-efficacy was an important factor for sexual satisfaction. The results of their study showed that the components of age, marital satisfaction, life satisfaction, and economic status affected women’s health status, which could be helpful in designing interventions to promote sexual health [38].

The results of our study indicated that the most social support was in the family subscale. Also, the women in the “non-distress marital quality” group had more family support and neighbor support. The results of a study indicated that social support of women with early marriages was in three emotional, instrumental, and informational dimensions, so emotional social support was among the factors influencing mental well-being [39]. On the other hand, it was reported in a study that there were social and cultural pressures and also financial motives for early marriage [40]. The findings of a study indicated that child marriage was affected by social and economic factors and was considered an acceptable social norm, becoming more complicated by poverty and the high illiteracy rate in society [41]. Therefore, if girls with early marriage are under social support, particularly under family support, they can spend their lives with less distress, while the families of most of these girls do not have a favorable financial and cultural status.

The results of our study indicated that sexual self-efficacy and social support were significantly and positively correlated with marital quality, but sexual satisfaction was significantly and negatively correlated with marital quality. In relationships between couples, a positive relationship usually exists between sexual satisfaction and marital satisfaction. However, the temporal dynamics of this relationship are controversial. According to Cao et al., there is no dynamic relationship between sexual satisfaction and marital satisfaction in the early years of marriage [42]. Shaud et al. reported that low marital adjustment and interpersonal communication style were significant predictors of psychological distress in women with early marriages [31]. The results of another study indicated a positive and significant correlation between marital distress and marital satisfaction among students [34]. Nindyasari et al. reported that the husband’s age and family interaction positively affected marital satisfaction, but the husband’s education level and age of marriage negatively affected marital satisfaction [43].

The results of a study indicated that personality traits and sexual self-efficacy were significantly correlated with marital satisfaction, and sexual self-efficacy could significantly play a mediating role between extroversion, neuroticism, and marital satisfaction. The authors of this study suggested that considering the effect of marital satisfaction on an individual’s physical and mental health, healthcare providers focus more on sexual self-efficacy [44].On the other hand, the results of a study indicated a significant and negative correlation between married women’s marital exhaustion and their sexual self-efficacy [45]. Yulfa et al.’s study, investigating the effects of social support and financial management on family well-being in early marriage, showed that social support was positively and significantly correlated with financial management, objective well-being, and mental well-being [39]. The results of a study indicated that social exchange could significantly contribute to predicting marital adjustment. Therefore, taking social exchange skills into consideration to improve the marital adjustment of married women with early marriages is recommended [46].

In general, numerous factors such as tradition, maintaining girls’ virginity, economic issues, and parents’ interest in establishing family relationships are among the principal causes of early marriage [47]. Early marriage and childbearing have widespread consequences [15]. Early marriage has many complications for women’s health. The rates of physical abuse, abortion, stillbirth, birth fistulas, premature birth, and termination of pregnancy are considerably associated with pregnancy in adolescence because of not having the necessary readiness [48]. Prevalence of early marriage is mostly observed among rural girls, girls without formal education, and unemployed girls. Therefore, empowering rural girls through promoting education is necessary to reduce early marriage [49].

Post-early marriage challenges can be reduced by providing proper social and health services during pregnancy and promoting young women’s awareness of contraceptives. Providing required training and psychological counseling for these women and their husbands will be greatly effective in married life. The results of the aforementioned study show that in women with early marriage, high marital quality does not always ensure their favorable sexual satisfaction. Moreover, high sexual self-efficacy and social support cause favorable marital quality.

Limitations

One of the limitations of the current study was that it was conducted only on women, and husbands did not participate in this research. It is recommended that a study be conducted to investigate sexual satisfaction and marital quality in both couples. Based on the results of the present research and given the relationship between some factors on women’s sexual satisfaction, it is suggested that health policymakers make constant efforts in this regard.

HIV Human immunodeficiency virus

AIDS Acquired immunodeficiency syndrome

BMI Body mass index

QMI Quality of Marriage Index

ISS Index of Sexual Satisfaction

SSQ Social Support Questionnaire

SPSS Statistical product service solution

Ethics approval and consent to participate

This study (IR.MUBABOL.REC.2022.148) was approved by the Ethics Committee of Babol University of Medical Sciences. Participants signed a written informed consent form before taking part in the study, in accordance with the guidelines of the Declaration of Helsinki.

Consent for publication

Not applicable.

Availability of data and materials

All data generated and analyzed during this study are included in this article. Datasets this study are available from the corresponding author upon reasonable request.

Competing interests

The authors declare that they have no competing interests.

Funding

This study was financially supported by the Babol University of Medical Sciences supported this study. The foundation has no role in the design, data collection, analysis and interpretation of the study findings.

Author contributions

H, A-R and F, Z contributed to the conception and design of the study. H, A-R; F, Z; M, A-D; F, B and M, KA guided the design and conduct of the study. H, A-R; F, Z and M, A-D were involved in data analysis and manuscript write-up analysis or interpretation.

Acknowledgments

The authors would like to thank Babol University of Medical Sciences, the Student Research Committee of Babol University of Medical Sciences and the study participants for their support.

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No competing interests reported.

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Associations of marital quality and sexual satisfaction in women with early marriage in Iran: a descriptive-correlational study

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