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Prenatal care demand and its effects on birth outcomes by birth defect status in Argentina

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  • Wehby, George L.
  • Murray, Jeffrey C.
  • Castilla, Eduardo E.
  • Lopez-Camelo, Jorge S.
  • Ohsfeldt, Robert L.

Abstract

Our objective was to identify determinants of prenatal care demand and evaluate the effects of this demand on low birth weight and preterm birth. Delay in initiating prenatal care was modeled as a function of pregnancy risk indicators, enabling factors, and regional characteristics. Conditional maximum likelihood (CML) estimation was used to model self-selection into prenatal care use when estimating its effectiveness. Birth registry data was collected post delivery on infants with and without common birth defects born in 1995-2002 in Argentina using a standard procedure. Several maternal health and fertility indicators had significant effects on prenatal care use. In the group without birth defects, prenatal care delay increased significantly LBW and preterm birth when accounting for self-selection using the CML model but not in the standard probit model. Prenatal care was found to be ineffective on average in the birth defect group. The self-selection of higher risk women into earlier initiation of prenatal care resulted in underestimation of prenatal care effectiveness when using a standard probit model with several covariates. Large improvements in birth outcomes are suggested with earlier initiation of prenatal care for pregnancies uncomplicated with birth defects in Argentina, implying large opportunity costs from the long waiting time observed in this sample (about 17 weeks on average). The suggested ineffectiveness for pregnancies complicated with common birth defects deserves further research.

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  • Wehby, George L. & Murray, Jeffrey C. & Castilla, Eduardo E. & Lopez-Camelo, Jorge S. & Ohsfeldt, Robert L., 2009. "Prenatal care demand and its effects on birth outcomes by birth defect status in Argentina," Economics & Human Biology, Elsevier, vol. 7(1), pages 84-95, March.
    • Handle: RePEc:eee:ehbiol:v:7:y:2009:i:1:p:84-95
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    1. Habibov, Nazim N. & Fan, Lida, 2011. "Does prenatal healthcare improve child birthweight outcomes in Azerbaijan? Results of the national Demographic and Health Survey," Economics & Human Biology, Elsevier, vol. 9(1), pages 56-65, January.
    2. Fidel Gonzalez & Santosh Kumar, 2018. "Prenatal care and birthweight in Mexico," Applied Economics, Taylor & Francis Journals, vol. 50(10), pages 1156-1170, February.
    3. Makate, Marshall, 2016. "Maternal health-seeking behavior and child’s birth order: Evidence from Malawi, Uganda, and Zimbabwe," MPRA Paper 72722, University Library of Munich, Germany, revised 14 Jul 2016.
    4. John Ele-Ojo Ataguba, 2018. "A reassessment of global antenatal care coverage for improving maternal health using sub-Saharan Africa as a case study," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-17, October.
    5. George L. Wehby & Kaitlin Prater & Ann Marie McCarthy & Eduardo E. Castilla & Jeffrey C. Murray, 2011. "The Impact of Maternal Smoking during Pregnancy on Early Child Neurodevelopment," Journal of Human Capital, University of Chicago Press, vol. 5(2), pages 207-254.
    6. Blessing J Akombi & Kingsley E Agho & Andre M Renzaho & John J Hall & Dafna R Merom, 2019. "Trends in socioeconomic inequalities in child undernutrition: Evidence from Nigeria Demographic and Health Survey (2003 – 2013)," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-13, February.
    7. Wehby, George L. & Castilla, Eduardo E. & Lopez-Camelo, Jorge, 2010. "The impact of altitude on infant health in South America," Economics & Human Biology, Elsevier, vol. 8(2), pages 197-211, July.
    8. Séverine Deguen & Wahida Kihal & Maxime Jeanjean & Cindy Padilla & Denis Zmirou-Navier, 2016. "Neighborhood Deprivation and Risk of Congenital Heart Defects, Neural Tube Defects and Orofacial Clefts: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-25, October.
    9. Grytten, Jostein & Skau, Irene & Sørensen, Rune J., 2014. "Educated mothers, healthy infants. The impact of a school reform on the birth weight of Norwegian infants 1967–2005," Social Science & Medicine, Elsevier, vol. 105(C), pages 84-92.
    10. George Wehby & Allen Wilcox & Rolv Lie, 2013. "The impact of cigarette quitting during pregnancy on other prenatal health behaviors," Review of Economics of the Household, Springer, vol. 11(2), pages 211-233, June.
    11. Jennifer Kane & S. Morgan & Kathleen Harris & David Guilkey, 2013. "The Educational Consequences of Teen Childbearing," Demography, Springer;Population Association of America (PAA), vol. 50(6), pages 2129-2150, December.
    12. Xiaoying Liu & Jere R Behrman & Aryeh D Stein & Linda S Adair & Santosh K Bhargava & Judith B Borja & Mariangela Freitas da Silveira & Bernardo L Horta & Reynaldo Martorell & Shane A Norris & Linda M , 2017. "Prenatal care and child growth and schooling in four low- and medium-income countries," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-21, February.
    13. Delajara, Marcelo & Wendelspiess Chávez Juárez, Florian, 2013. "Birthweight outcomes in Bolivia: The role of maternal height, ethnicity, and behavior," Economics & Human Biology, Elsevier, vol. 11(1), pages 56-68.
    14. Wehby George L. & McCarthy Ann Marie & Castilla Eduardo & Murray Jeffrey C., 2011. "The Impact of Household Investments on Early Child Neurodevelopment and on Racial and Socioeconomic Developmental Gaps: Evidence from South America," Forum for Health Economics & Policy, De Gruyter, vol. 14(2), pages 1-60, December.

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