Demography

, Volume 48, Issue 4, pp 1473–1491 | Cite as

The Effect of Maternal Stress on Birth Outcomes: Exploiting a Natural Experiment

Article

Abstract

A growing body of research highlights that in utero conditions are consequential for individual outcomes throughout the life cycle, but research assessing causal processes is scarce. This article examines the effect of one such condition—prenatal maternal stress—on birth weight, an early outcome shown to affect cognitive, educational, and socioeconomic attainment later in life. Exploiting a major earthquake as a source of acute stress and using a difference-in-difference methodology, I find that maternal exposure to stress results in a significant decline in birth weight and an increase in the proportion of low birth weight. This effect is focused on the first trimester of gestation, and it is mediated by reduced gestational age rather than by factors affecting the intrauterine growth of term infants. The findings highlight the relevance of understanding the early emergence of unequal outcomes and of investing in maternal well-being since the onset of pregnancy.

Keywords

Stress Birth weight Gestational age Preterm birth Natural experiment 

References

  1. Ai, C., & Norton, E. (2003). Interaction terms in logit and probit models. Economics Letters, 80, 123–129.CrossRefGoogle Scholar
  2. Almond, D., Chay, K., & Lee, D. (2005). The costs of low birth weight. Quarterly Journal of Economics, 120, 1031–1083.Google Scholar
  3. Aneshensel, C. S. (1992). Social stress: Theory and research. Annual Review of Sociology, 18, 15–38.CrossRefGoogle Scholar
  4. Angrist, J., Imbens, G., & Rubin, D. (1996). Identification of causal effects using instrumental variables. Journal of the American Statistical Association, 91, 444–455.CrossRefGoogle Scholar
  5. Austin, M.-P., & Leade, L. (2000). Maternal stress and obstetric and infant outcomes: Epidemiological findings and neuroendocrine mechanisms. Australian and New Zealand Journal of Obstetrics and Gynaecology, 40, 331–337.CrossRefGoogle Scholar
  6. Bale, J. R., Stoll, B. J., & Lucas, A. O. (Eds.). (2003). Improving birth outcomes: Meeting the challenge in the developing world. Washington, DC: National Academies Press.Google Scholar
  7. Barker, D. J., Gluckman, P. D., Godfrey, K. M., Harding, J. E., Owens, J. A., & Robinson, J. S. (1993). Fetal nutrition and cardiovascular disease in adult life. Lancet, 341, 938–941.CrossRefGoogle Scholar
  8. Behrman, J., & Rosenzweig, M. (2004). The returns to birth weight. The Review of Economics and Statistics, 86, 586–601.CrossRefGoogle Scholar
  9. Behrman, R., & Stith-Butler, A. (2007). Preterm birth: Causes, consequences and prevention. Washington, DC: National Academies Press.Google Scholar
  10. Bitler, M. P., & Currie, J. (2005). Does WIC work? The effects of WIC on pregnancy and birth outcomes. Journal of Policy Analysis and Management, 24, 73–91.CrossRefGoogle Scholar
  11. Black, S. E., Devereux, P. J., & Salvanes, K. G. (2007). From the cradle to the labor market? The effect of birth weight on adult outcomes. Quarterly Journal of Economics, 22, 409–439.CrossRefGoogle Scholar
  12. Boardman, J., Powers, D., Padilla, Y., & Hummer, R. (2002). Low birth weight, social factors, and developmental outcomes among children in the United States. Demography, 39, 353–368.CrossRefGoogle Scholar
  13. Brooks-Gunn, J., McCarton, C. M., Casey, P. H., McCormick, M. C., Bauer, C. R., Bernbaum, J. C., . . .Tonascia, J. (1994). Early intervention in low-birth-weight premature infants: Results through age 5 years from the Infant Health and Development Program. Journal of the American Medical Association, 272, 1257–1262.Google Scholar
  14. Browne, T. (1672). Religio medici. London, UK: Andrew Crook.Google Scholar
  15. Case, A., Fertig, A., & Paxson, C. (2005). The lasting impact of childhood health and circumstance. Journal of Health Economics, 24, 365–389.CrossRefGoogle Scholar
  16. Catalano, R., & Hartig, T. (2001). Communal bereavement and the incidence of very low birthweight in Sweden. Journal of Health and Social Behavior, 42, 333–341.CrossRefGoogle Scholar
  17. Collins, J., David, R., Symons, R., Handler, A., Wall, S., & Dwyer, L. (2000). Low-income African-American mothers’ perception of exposure to racial discrimination and infant birth weight. Epidemiology, 11, 337–339.CrossRefGoogle Scholar
  18. Conley, D., & Bennett, N. G. (2000). Is biology destiny? Birth weight and life chances. American Sociological Review, 65, 458–467.CrossRefGoogle Scholar
  19. Conley, D., Strully, K. W., & Bennett, N. G. (2003). The starting gate. Birth weight and life chances. Berkeley: University of California Press.Google Scholar
  20. Copper, R. L., Goldenberg, R. L., Das, A., Elder, N., Swain, M., Norman, G.,. . . Meier, A. M. (1996). The Preterm Prediction Study: Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks’ gestation. American Journal of Obstetrics and Gynecology, 175, 1286–1292.Google Scholar
  21. Currie, J., & Hyson, R. (1999). Is the impact of health shocks cushioned by socioeconomic status? The case of low birthweight. The American Economic Review, 89, 245–250.CrossRefGoogle Scholar
  22. De Weerth, C., & Buitelaar, J. K. (2005). Physiological stress reactivity in human pregnancy—A review. Neurosciences Biobehavioral Review, 29, 295–312.CrossRefGoogle Scholar
  23. Dimsdale, J. (2008). Psychological stress and cardiovascular disease. Journal of the American College of Cardiology, 51, 1237–1246.CrossRefGoogle Scholar
  24. Dole, N., Savitz, D. A., Hertz-Picciotto, I., Siega-Riz, A. M., McMahon, M. J., & Buekens, P. (2003). Maternal stress and preterm birth. American Journal of Epidemiology, 157, 14–24.CrossRefGoogle Scholar
  25. Earthquake Engineering Research Institute (EERI). (2005). Intensities and damage distribution in the June 2005 Tarapaca, Chile, earthquake (EERI Special Earthquake Report). Oakland, CA: Author.Google Scholar
  26. Eskenazi, B., Marks, A. R., Catalano, R., Bruckner, T., & Toniolo, P. G. (2007). Low birthweight in New York City and upstate New York following the events of September 11th. Human Reproduction, 22, 3013–3020.CrossRefGoogle Scholar
  27. Gelman, A., & Hill, J. (2007). Data analysis using regression and multilevel/hierarchical models. New York: Cambridge University Press.Google Scholar
  28. Giles, W. B., McLean, M., Davies, J. J., & Smith, R. (1996). Abnormal umbilical artery Doppler waveforms and cord blood corticotrophin-releasing hormone. Obstetrics and Gynecology, 87, 107–111.CrossRefGoogle Scholar
  29. Gluckman, P. D., & Hanson, M. A. (2009). Developmental plasticity and the developmental origins of health and disease. In J. P. Newnham & M. G. Ross (Eds.), Early life origins of health and disease (pp. 1–10). Basel: Karger.CrossRefGoogle Scholar
  30. Glynn, L. M., Wadhwa, P. D., Dunkel-Schetter, C., Chicz-Demet, A., & Sandman, C. A. (2001). When stress happens matters: Effects of earthquake timing on stress responsivity in pregnancy. American Journal of Obstetrics and Gynecology, 184, 637–642.CrossRefGoogle Scholar
  31. Glynn, L. M., Dunkel-Schetter, C., Wadhwa, P. D., & Sandman, C. A. (2004). Pregnancy affects appraisal of negative life events. Journal of Psychosomatic Research, 56, 47–52.CrossRefGoogle Scholar
  32. Goland, R. S., Jozak, S., Warren, W. B., Conwell, I. M., Stark, R. I., & Tropper, P. J. (1993). Elevated levels of. umbilical cord plasma corticotropin-releasing hormone in growth-retarded fetuses. Journal of Clinical Endocrinology and Metabolism, 77, 1174–1179.CrossRefGoogle Scholar
  33. Gonzalez, R., Gomez, R., Castro, R. Nien, J., Merino, P., Etchegaray, A.,. . . Rojas, I. (2004). A national birth weight distribution curve according to gestational age in Chile from 1993 to 2000. Revista Medica de Chile, 132, 1155–1165.Google Scholar
  34. Gortmaker, S., & Wise, P. (1997). The first injustice: Socioeconomic disparities, health services technology, and infant mortality. Annual Review of Sociology, 23, 140–170.CrossRefGoogle Scholar
  35. Hales, C. N., Barker, D. J., Clark, P. M., Cox, L. J., Fall, C., Osmond, C., & Winter, P. D. (1991). Fetal and infant growth and impaired glucose tolerance at age 64. British Medical Journal, 303, 1019–1022.Google Scholar
  36. Heckman, J. (2006). Skill formation and the economics of investment in disadvantaged children. Science, 312, 1900–1902.CrossRefGoogle Scholar
  37. Hedegaard, M., Henriksen, T. B., Sabroe, S., & Secher, N. J. (1996). The relationship between psychological distress during pregnancy and birth weight for gestational age. Acta Obstetricia et Gynecologica Scandinavica, 75, 32–39.CrossRefGoogle Scholar
  38. Hidalgo, P., & Arias, A. (1990). New Chilean code for earthquake-resistant design of buildings. Proceedings 4th US National Conference on Earthquake Engineering, 2, 927–936.Google Scholar
  39. Hobel, C. (2004). Stress and preterm birth. Clinical Obstetrics and Gynecology, 47, 856–880. discussion: 881–852.CrossRefGoogle Scholar
  40. Hobel, C., & Culhane, J. (2003). Role of psychosocial and nutritional stress on pregnancy outcome. Journal of Nutrition, 133, 1709S–1717S.Google Scholar
  41. Hobel, C. J., Goldstein, A., & Barrett, E. S. (2008). Psychosocial stress and pregnancy outcome. Clinical Obstetrics and Gynecology, 51, 333–348.CrossRefGoogle Scholar
  42. House, J., Landis, K., & Umberson, D. (1988). Social relationships and stress. Science, 241, 540–545.CrossRefGoogle Scholar
  43. Imbens, G. (2004). Nonparametric estimation of average treatment effects under exogeneity: A review. The Review of Economics and Statistics, 86, 4–29.CrossRefGoogle Scholar
  44. Instituto Nacional de Estadísticas (INE). (2005). Informe economico regional 2005 (Report). Retrieved from http://www.ine.cl/canales/chile_estadistico/territorio/iner/iner.php
  45. Instituto Nacuibak de Estadisticas (INE). (2006). Informe economico regional 2006 (Report). Retrieved from http://www.ine.cl/canales/chile_estadistico/territorio/iner/iner.php
  46. Kline, J., Stein, Z., & Susser, M. (1989). Conception to birth: Epidemiology of prenatal development. New York: Oxford University Press.Google Scholar
  47. Kramer, M. S., Goulet, L., Lydon, J., Séguin, L., McNamara, H., Dassa, C., . . .Koren, G. (2001). Socio-economic disparities in preterm birth: Causal pathways and mechanisms. Paediatric and Perinatal Epidemiology, 15(Suppl. 2), 104–123.Google Scholar
  48. Lauderdale, D. S. (2006). Birth outcomes for Arabic-named women in California before and after September 11. Demography, 43, 185–201.CrossRefGoogle Scholar
  49. Leor, J., Poole, W. K., & Kloner, R. A. (1996). Sudden cardiac death triggered by an earthquake. The New England Journal of Medicine, 334, 413–419.CrossRefGoogle Scholar
  50. Lockwood, C. J. (1999). Stress-associated preterm delivery: The role of corticotropin-releasing hormone. American Journal of Obstetrics and Gynecology, 180, S264–S266.CrossRefGoogle Scholar
  51. Lui, S., Huang, X., Chen, L., Tang, H., Zhang, T., Li, X., . . .Gong, Q. (2009). High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China. Proceedings of the National Academy of Sciences, 106, 15412–15417.Google Scholar
  52. Majzoub, J. A., McGregor, J. A., Lockwood, C. J., Smith, R., Taggart, M. S., & Schulkin, J. (1999). A central theory of preterm and term labor: Putative role for corticotrophin-releasing hormone. American Journal of Obstetrics and Gynecology, 180, S232–S234.CrossRefGoogle Scholar
  53. Mancuso, R. S., Dunkel-Schetter, C., Rini, C. M., Roesch, S. C., & Hobel, C. J. (2004). Maternal prenatal anxiety and corticotropin-releasing hormone associated with timing of delivery. Psychosomatic Medicine, 66, 762–769.CrossRefGoogle Scholar
  54. Mardones, F., Villarroel, L., Karzulovic, L., Barja, S., Arnaiz, P., Taibo, M., & Mardones-Restat, F. (2008). Association of perinatal factors and obesity in 6- to 8-year-old Chilean children. International Journal of Epidemiology, 37, 902–910.Google Scholar
  55. Mathews, T. J., & MacDorman, M. F. (2008). Infant mortality statistics from the 2005 period linked birth/infant death data set. National Vital Statistics Reports 57. Hyattsville, MD: National Center for Health Statistics.Google Scholar
  56. McEwen, B. (1998). Protective and damaging effects of stress mediators. The New England Journal of Medicine, 338, 171–179.CrossRefGoogle Scholar
  57. McLean, M., Bisits, A., Davies, J., Woods, R., Lowry, P., & Smith, R. (1995). A placental clock controlling the length of human pregnancy. Nature Medicine, 1, 460–463.CrossRefGoogle Scholar
  58. McLean, M., Bisits, A., Davies, J., Walters, W., Hackshaw, A., De Voss, K., & Smith, R. (1999). Predicting risk of preterm delivery by second-trimester measurement of maternal plasma corticotropin-releasing hormone and α-fetoprotein concentrations. American Journal of Obstetrics and Gynecology, 181, 207–215.Google Scholar
  59. Ministry of Planning Chile. (2006). Encuesta de Caracterizacion Socioeconomica (CASEN) 2006. Computer file. Retrieved from http://www.mideplan.gob.cl/casen/bases_datos.html
  60. Mulder, E. J., Robles de Medina, P. G., Huizink, A. C., Van den Bergh, B. R., Buitelaar, J. K., & Visser, G. H. (2002). Prenatal maternal stress: Effects on pregnancy and the (unborn) child. Early Human Development, 70, 3–14.CrossRefGoogle Scholar
  61. Nepomnaschy, P. A., Welch, K. B., McConnell, D. S., Low, B. S., Strassmann, B. I., & England, B. G. (2006). Cortisol levels and very early pregnancy loss in humans. Proceedings of the National Academy of Sciences, 103, 3938–3942.CrossRefGoogle Scholar
  62. Norbeck, J. S., DeJoseph, J. F., & Smith, R. T. (1996). A randomized trial of an empirically-derived social support intervention to prevent low birthweight among African American women. Social Science & Medicine, 43, 947–954.CrossRefGoogle Scholar
  63. Nordentoft, M., Lou, H. C., Hansen, D., Nim, J., Pryds, O., Rubin, P., et al. (1996). Intrauterine growth retardation and premature delivery: The influence of maternal smoking and psychosocial factors. American Journal of Public Health, 86, 347–354.CrossRefGoogle Scholar
  64. ONEMI Oficina Nacional de Emergencia Chile. (2005). Informe consolidado. Terremoto primera region de Tarapaca. Santiago, Chile: Departamento de Proteccion Civil.Google Scholar
  65. Oreopoulos, P., Stabile, M., Walld, R., & Roos, L. L. (2008). Short-, medium-, and long-term consequences of poor infant health: An analysis using siblings and twins. Journal of Human Resources, 43, 88–138.Google Scholar
  66. Pallotto, E. K., & Kilbride, H. W. (2006). Perinatal outcome and later implications of intrauterine growth restriction. Clinical Obstetrics and Gynecology, 49, 257–269.CrossRefGoogle Scholar
  67. Paneth, N. (1995). The problem of low birth weight. The Future of Children, 5, 19–34.CrossRefGoogle Scholar
  68. Pearlin, L., Schieman, S., Fazio, E., & Meersman, S. (2005). Stress, health, and the life course: Some conceptual perspectives. Journal of Health and Social Behavior, 46, 205–219.CrossRefGoogle Scholar
  69. Ramirez, M., & Peek-Asa, C. (2005). Epidemiology of traumatic injuries from earthquakes. Epidemiologic Reviews, 27, 47–55.CrossRefGoogle Scholar
  70. Rosenbaum, P. (1984). From association to causation in observational studies: The role of tests of strongly ignorable treatment assignment. Journal of the American Statistical Association, 79, 41–48.CrossRefGoogle Scholar
  71. Rosenbaum, P. (2001). Replicating effects and biases. The American Statistician, 55, 223–227.CrossRefGoogle Scholar
  72. Rosenzweig, M., & Wolpin, K. (2000). Natural “natural experiments” in economics. Journal of Economic Literature, 38, 827–874.CrossRefGoogle Scholar
  73. Rubin, D. (1980). Comment on “Randomization analysis of experimental data in the Fisher randomization test” by Basu. Journal of the American Statistical Association, 75, 591–593.CrossRefGoogle Scholar
  74. Sandman, C., Glynn, L., Dunkel-Schetter, C., Wadhwa, P., Garite, T., Chicz-DeMet, A., & Hobel, C. (2006). Elevated maternal cortisol early in pregnancy predicts third trimester levels of placental corticotropin releasing hormone (CRH): Priming the placental clock. Peptides, 27, 1457–1463.CrossRefGoogle Scholar
  75. Sapolsky, R. (2004). Why zebras don’t have ulcers (3rd ed.). New York: Holt.Google Scholar
  76. Scawthorn, C. (2003). Earthquakes: Seismogenesis, measurement, and distribution. In W. Chen & C. Scawthorn (Eds.), Earthquake engineering handbook (chap. 4). Boca Raton, FL: CRC.Google Scholar
  77. Schneiderman, N., Ironson, G., & Siegel, S. (2005). Stress and health: Psychological, behavioral, and biological determinants. Annual Review of Clinical Psychology, 1, 607–628.CrossRefGoogle Scholar
  78. Shonkoff, J., & Phillips, D. (2000). From neurons to neighborhoods: The science of early childhood development. Washington, DC: National Academy Press.Google Scholar
  79. Siegel, J. M. (2000). Emotional injury and the Northridge, California earthquake. Natural Hazards Review, 1, 204–211.CrossRefGoogle Scholar
  80. Turner, R., Wheaton, B., & Lloyd, D. (1995). The epidemiology of social stress. American Sociological Review, 60, 104–125.CrossRefGoogle Scholar
  81. Wadhwa, P., Porto, M., Garite, T., Chicz-DeMet, A., & Sandman, C. (1998). Maternal corticotropin-releasing hormone levels in the early third trimester predict length of gestation in human pregnancy. American Journal of Obstetrics and Gynecology, 179, 1079–1085.CrossRefGoogle Scholar
  82. Wadhwa, P. D., Garite, T. J., Porto, M., Glynn, L., Chicz-DeMet, A., Dunkel-Schetter, C., & Sandman, C. A. (2004). Placental corticotropin-releasing hormone (CRH), spontaneous preterm birth, and fetal growth restriction: A prospective investigation. American Journal of Obstetrics and Gynecology, 191, 1063–1069.CrossRefGoogle Scholar
  83. Wisner, B., Blaikie, T., Cannon, T., & Davis, I. (2004). At risk: Natural hazards, people’s vulnerability and disasters (2nd ed.). London, UK: Routledge.Google Scholar

Copyright information

© Population Association of America 2011

Authors and Affiliations

  1. 1.Department of SociologyNew York UniversityNew YorkUSA

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