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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.
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    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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    Bibliographic Info

    Article provided by Elsevier in its journal Economics & Human Biology.

    Volume (Year): 7 (2009)
    Issue (Month): 1 (March)
    Pages: 84-95

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    Handle: RePEc:eee:ehbiol:v:7:y:2009:i:1:p:84-95

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    Web page: http://www.elsevier.com/locate/inca/622964

    Related research

    Keywords: Prenatal care Low birth weight Preterm birth Conditional maximum likelihood Birth outcomes Health production Argentina South America;

    References

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    1. Jeffrey J. Rous & R. Todd Jewell & Robert W. Brown, 2004. "The effect of prenatal care on birthweight: a full-information maximum likelihood approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 251-264.
    2. Nancy E. Reichman & Hope Corman & Kelly Noonan & Dhaval Dave, 2006. "Typically Unobserved Variables (TUVs) and Selection into Prenatal Inputs: Implications for Estimating Infant Health Production Functions," Working Papers 930, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Migration and Development..
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    Citations

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    Cited by:
    1. Jennifer Kane & S. Morgan & Kathleen Harris & David Guilkey, 2013. "The Educational Consequences of Teen Childbearing," Demography, Springer, vol. 50(6), pages 2129-2150, December.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.

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