Objectives: We aimed to examine whether an association exists between maternal high-risk fertility behavior and chronic undernutrition among children under 5 y of age. In addition, we explored the relationship between poverty and high-risk fertility behavior and the relative roles they play as obstacles in the reduction of the risk of undernutrition among children.

Methods: The analysis was based on responses from married women ages 15 to 49 who lived with at least one child under the age of 5; and three cross-sectional, nationally representative samples from India, Bangladesh, and Nepal were considered.

Results: Maternal high-risk fertility behavior was associated with an increased risk of chronic undernutrition among children in India, Bangladesh, and Nepal. Multiple high-risk categories appeared to have more profound consequences on the outcomes measured. Findings also demonstrated that with regard to the risk of undernutrition, children of mothers who were either poor or who experienced high-risk fertility were not uniquely disadvantaged.

Conclusions: The results suggest that with regard to the risk of chronic undernutrition, the negative effect of high-risk fertility behavior extends across all economic backgrounds and is not limited to children of mothers who were either poor or who experienced high-risk fertility.