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The Effectiveness of Prenatal Care in a Low Income Population: A Panel Data Approach


  • Ana I. Balsa


  • Patricia Triunfo


This paper analyzes the impact of prenatal care on the likelihood of low birth weight and prematurity using panel data on births taking place between 1995 and 2008 in the largest maternity ward in Uruguay. The use of difference-Generalized Method of Moments estimation addresses biases due to time invariant unobserved heterogeneity and feedback effects from prior pregnancies. Our estimates are larger than those usually found for developed countries: an adequate use of prenatal care - as defined by the Kessner criterion - decreases the probability of low birth weight by half and the likelihood of a pre-term birth by 70%. Even when imposing less stringent requirements on the total number of prenatal controls, the improvements over birth outcomes are considerable. In addition to indicating the crucial role of prenatal care in the birth outcomes of low-income populations, our analysis highlights the importance of using econometric techniques that use the full distribution of pregnancies to estimate the effectiveness of prenatal care.

Suggested Citation

  • Ana I. Balsa & Patricia Triunfo, 2012. "The Effectiveness of Prenatal Care in a Low Income Population: A Panel Data Approach," Documentos de Trabajo/Working Papers 1204, Facultad de Ciencias Empresariales y Economia. Universidad de Montevideo..
  • Handle: RePEc:mnt:wpaper:1204

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    1. Currie, Janet & Grogger, Jeffrey, 2002. "Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?," Journal of Health Economics, Elsevier, vol. 21(2), pages 313-335, March.
    2. Kai Li & Dale J. Poirier, 2003. "Bayesian analysis of an econometric model of birth inputs and outputs," Journal of Population Economics, Springer;European Society for Population Economics, vol. 16(3), pages 597-625, August.
    3. Sandra E. Black & Paul J. Devereux & Kjell G. Salvanes, 2007. "From the Cradle to the Labor Market? The Effect of Birth Weight on Adult Outcomes," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 409-439.
    4. R. Todd Jewell & Patricia Triunfo, 2006. "The impact of prenatal care on birthweight: the case of Uruguay," Health Economics, John Wiley & Sons, Ltd., vol. 15(11), pages 1245-1250.
    5. Jason Boardman & Daniel Powers & Yolanda Padilla & Robert Hummer, 2002. "Low birth weight, social factors, and developmental outcomes among children in the United States," Demography, Springer;Population Association of America (PAA), vol. 39(2), pages 353-368, May.
    6. Janet Currie & Enrico Moretti, 2007. "Biology as Destiny? Short- and Long-Run Determinants of Intergenerational Transmission of Birth Weight," Journal of Labor Economics, University of Chicago Press, vol. 25, pages 231-264.
    7. Jason Abrevaya, 2006. "Estimating the effect of smoking on birth outcomes using a matched panel data approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 21(4), pages 489-519.
    8. James Cramer, 1995. "Racial and Ethnic Differences in Birthweight: The Role of Income and Financial Assistance," Demography, Springer;Population Association of America (PAA), vol. 32(2), pages 231-247, May.
    9. Guilkey, David K. & Popkin, Barry M. & Akin, John S. & Wong, Emelita L., 1989. "Prenatal care and pregnancy outcome in Cebu, Philippines," Journal of Development Economics, Elsevier, vol. 30(2), pages 241-272, April.
    10. Li, Kai & Poirier, Dale J., 2003. "An econometric model of birth inputs and outputs for Native Americans," Journal of Econometrics, Elsevier, vol. 113(2), pages 337-361, April.
    11. Grossman, Michael & Joyce, Theodore J, 1990. "Unobservables, Pregnancy Resolutions, and Birth Weight Production Functions in New York City," Journal of Political Economy, University of Chicago Press, vol. 98(5), pages 983-1007, October.
    12. Case, Anne & Fertig, Angela & Paxson, Christina, 2005. "The lasting impact of childhood health and circumstance," Journal of Health Economics, Elsevier, vol. 24(2), pages 365-389, March.
    13. repec:aph:ajpbhl:1994:84:9:1414-1420_1 is not listed on IDEAS
    14. George L. Wehby & Jeffrey C. Murray & Eduardo E. Castilla & Jorge S. Lopez-Camelo & Robert L. Ohsfeldt, 2009. "Quantile effects of prenatal care utilization on birth weight in Argentina," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1307-1321.
    15. Mark R. Rosenzweig & T. Paul Schultz, 1988. "The Stability of Household Production Technology: A Replication," Journal of Human Resources, University of Wisconsin Press, vol. 23(4), pages 535-549.
    16. Nancy E. Reichman & Hope Corman & Kelly Noonan & Dhaval Dave, 2009. "Infant health production functions: what a difference the data make," Health Economics, John Wiley & Sons, Ltd., vol. 18(7), pages 761-782.
    17. Theodore Joyce & Michael Grossman, 1990. "Pregnancy wantedness and the early initiation of prenatal care," Demography, Springer;Population Association of America (PAA), vol. 27(1), pages 1-17, February.
    18. Paula Veiga & Ronald P. Wilder, 2006. "Maternal smoking during pregnancy and birthweight - A propensity score matching approach," NIMA Working Papers 32, Núcleo de Investigação em Microeconomia Aplicada (NIMA), Universidade do Minho.
    19. W. Frisbie & Douglas Forbes & Starling Pullum, 1996. "Compromised birth outcomes and infant mortality among racial and ethnic groups," Demography, Springer;Population Association of America (PAA), vol. 33(4), pages 469-481, November.
    20. Jewell R. Todd & Patricia Triunfo & Rafael Aguirre, 2007. "El peso al nacer de los niños de la principal maternidad de Uruguay: 1995 a 2004," REVISTA DESARROLLO Y SOCIEDAD, UNIVERSIDAD DE LOS ANDES-CEDE, February.
    21. Conway, Karen Smith & Deb, Partha, 2005. "Is prenatal care really ineffective? Or, is the 'devil' in the distribution?," Journal of Health Economics, Elsevier, vol. 24(3), pages 489-513, May.
    22. Robert Kaestner & Won Chan Lee, 2005. "The effect of welfare reform on prenatal care and birth weight," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 497-511.
    23. Geoffrey Warner, 1998. "Birthweight Productivity of Prenatal Care," Southern Economic Journal, Southern Economic Association, vol. 65(1), pages 42-63, July.
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    More about this item


    prenatal care; panel data; difference GMM; lowbirth weight; low SES populations;

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General

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