, Volume 51, Issue 5, pp 1775–1796 | Cite as

The Effects of Intrauterine Malnutrition on Birth and Fertility Outcomes: Evidence From the 1974 Bangladesh Famine

  • Rey Hernández-Julián
  • Hani Mansour
  • Christina Peters


This article uses the Bangladesh famine of 1974 as a natural experiment to estimate the impact of intrauterine malnutrition on sex of the child and infant mortality. In addition, we estimate the impact of malnutrition on post-famine pregnancy outcomes. Using the 1996 Matlab Health and Socioeconomic Survey (MHSS), we find that women who were pregnant during the famine were less likely to have male children. Moreover, children who were in utero during the most severe period of the Bangladesh famine were 32 % more likely to die within one month of birth compared with their siblings who were not in utero during the famine. Finally, we estimate the impacts of the famine on subsequent pregnancy outcomes. Controlling for pre-famine fertility, we find that women who were pregnant during the famine experienced a higher number of stillbirths in the post-famine years. This increase appears to be driven by an excess number of male stillbirths.


Famine Fertility Fetal origins Trivers-Willard Infant mortality 



We are grateful to Daniel Rees, Angela Dills, and Martha Bailey for useful comments on an earlier version of this article.


  1. Alamgir, M. (1980). Famine in South Asia: Political economy of mass starvation. Cambridge, MA: Oelgeschlager, Gunn and Hain.Google Scholar
  2. Alamgir, M., & Salimullah. (1977). Famine, 1974: Political economy of mass starvation in Bangladesh: A statistical annexe. Dacca: Bangladesh Institute of Development Studies.Google Scholar
  3. Almond, D. (2006). Is the 1918 influenza pandemic over? Long-term effects of in utero influenza exposure in the post-1940 U.S. population. Journal of Political Economy, 114, 672–712.CrossRefGoogle Scholar
  4. Almond, D., & Currie, J. (2011). Killing me softly: The fetal origin hypothesis. Journal of Economic Perspectives, 25, 153–172.CrossRefGoogle Scholar
  5. Almond, D., & Edlund, L. (2007). Trivers-Willard at birth and one year: Evidence from US natality data 1983–2001. Proceedings of the Royal Society B, 274, 2491–2496.CrossRefGoogle Scholar
  6. Almond, D., Edlund, L., Li, H., & Zhang, J. (2008). Long-term effects of early life development: Evidence from the 1959–1961 China famine. In T. Ito & A. Rose (Eds.), The economic consequences of demographic change in East Asia (pp. 321–345). Cambridge, MA: National Bureau of Economic Research.Google Scholar
  7. Almond, D., & Mazumder, B. (2011). Health capital and the pre-natal environment: The effect of Ramadan observance during pregnancy. American Economic Journals: Applied Economics, 3(4), 56–85.Google Scholar
  8. Anderson, R., & Bergstrom, S. (1998). Is maternal malnutrition associated with a low sex ratio at birth? Human Biology, 70, 1101–1106.Google Scholar
  9. Bairagi, R. (1986). Food crisis, nutrition, and female children in rural Bangladesh. Population and Development Review, 12, 307–315.CrossRefGoogle Scholar
  10. Barker, D. J. (1990). The fetal and infant origins of adult disease. BMJ, 301, 1111.CrossRefGoogle Scholar
  11. Binswinger, H., & Rosenzweig, M. (1986). Behavioural and material determinants of production relations in agriculture. Journal of Development Studies, 22, 503–539.CrossRefGoogle Scholar
  12. Bulik, C. M., Sullivan, P. F., Fear, J. L., Pickering, A., Dawn, A., & McCullin, M. (1999). Fertility and reproduction in women with anorexia nervosa: A controlled study. Journal of Clinical Psychiatry, 60, 130–135.CrossRefGoogle Scholar
  13. Camacho, A. (2008). Stress and birth weight: Evidence from terrorist attack. American Economic Review, 98, 511–515.CrossRefGoogle Scholar
  14. Cameron, E. Z. (2004). Facultative adjustment of mammalian sex ratios in support of the Trivers-Willard hypothesis: Evidence for a mechanism. Proceedings of the Royal Society, 271, 1723–1728.CrossRefGoogle Scholar
  15. Choe, M. K., & Razzaque, A. (1990). Effect of famine on child survival in Matlab, Bangladesh. Asia-Pacific Population Journal, 5(2), 53–72.Google Scholar
  16. Collins, S. (1995). The limit of human adaptation to starvation. Nature Medicine, 1, 810–814.CrossRefGoogle Scholar
  17. Davis, A. P. (1996). Targeting the vulnerable in emergency situations: Who is vulnerable? The Lancet, 348, 868–871.CrossRefGoogle Scholar
  18. Dyson, T. (1991). On the demography of South Asian famines—Part II. Population Studies, 45, 279–297.CrossRefGoogle Scholar
  19. Fauveau, V., & Chakraborty, J. (1994). Family planning and maternal and child health services in Matlab. In V. Fauveau (Ed.), Matlab: Women, children and health (Special Publication No. 35, pp. 89–107). Dhaka, Bangladesh: International Centre for Diarrhoeal Disease Research.Google Scholar
  20. Hart, N. (1993). Famine, maternal nutrition and infant mortality: A re-examination of the Dutch Hunger Winter. Population Studies, 47, 27–46.CrossRefGoogle Scholar
  21. Huck, W. U., Labov, J. B., & Lisk, R. D. (1986). Food restricting young hamsters (Mesocricetus auratus) affects sex ratio and growth of sebsequent offspring. Biology of Reproduction, 35, 592–598.CrossRefGoogle Scholar
  22. India Famine Inquiry Commission. (1976). Report on Bengal. New York, NY: Arno Press.Google Scholar
  23. Janowitz, B., Holtman, M., Hubacher, D., & Jamil, K. (1997). Can the Bangladeshi Family Planning Program meet rising needs without raising costs? International Family Planning Perspectives, 23, 116–121.CrossRefGoogle Scholar
  24. Joshi, S., & Schultz, P. T. (2007). Family planning as an investment in development: Evaluation of a program’s consequences in Matlab, Bangladesh (Economic Growth Center Discussion Paper No. 951). New Haven, CT: Yale University.Google Scholar
  25. Kannisto, V., Christensen, K., & Vaupel, J. W. (1997). No increased mortality in later life for cohorts born during famine. American Journal of Epidemiology, 145, 987–994.CrossRefGoogle Scholar
  26. Katz, M., & Vollenhoven, B. (2000). The reproductive endocrine consequences of anorexia nervosa. British Journal of Obstetrics and Gynaecology, 107, 707–713.CrossRefGoogle Scholar
  27. Koenig, M. A., & D’Souza, S. (1986). Sex differences in childhood mortality in rural Bangladesh. Social Science & Medicine, 22, 15–22.CrossRefGoogle Scholar
  28. Kuhn, R. S. (2005). The determinants of family and individual migration: A case-study of rural Bangladesh (Research Program on Population Processes Working Paper POP2005-05). Boulder, CO: Institute of Behavioral Science.Google Scholar
  29. Langsten, R. (1981). The effects of crises on differential mortality by sex in Bangladesh. Bangladesh Development Studies, 9(2), 75–96.Google Scholar
  30. Lindeboom, M., Portrait, F., & van den Berg, G. J. (2010). Long-run effects on longevity of a nutritional shock early in life: The Dutch Potato Famine of 1846–1847. Journal of Health Economics, 29, 617–629.CrossRefGoogle Scholar
  31. Lumey, L. H., & Stein, A. D. (1997). Offspring birth weights after maternal intrauterine undernutrition: A comparison within sibships. American Journal of Epidemiology, 146, 810–819.CrossRefGoogle Scholar
  32. Mansour, H., & Rees, D. I. (2012). Armed conflict and birth weight: Evidence from the Al-Aqsa Intifada. Journal of Development Economics, 99, 190–199.CrossRefGoogle Scholar
  33. Meikle, D. B., & Drickamer, L. C. (1986). Food availability and secondary sex ratio variation in wild laboratory house mice (Mus musculus). Journal of Reproduction and Fertility, 78, 587–591.CrossRefGoogle Scholar
  34. Neugebauer, R., Hoek, H. W., & Susser, E. (1999). Prenatal exposure to wartime famine and development of antisocial personality disorder in early adulthood. Journal of the American Medical Association, 282, 455–462.CrossRefGoogle Scholar
  35. Painter, R. C., Rosenboom, T. J., & Bleker, O. P. (2005). Prenatal exposure to the Dutch famine and disease in later life: An overview. Reproductive Toxicology, 20, 345–352.CrossRefGoogle Scholar
  36. Pitt, M., & Khandker, S. (1998). The impact of group-based credit programs on poor households in Bangladesh: Does the gender of participants matter? Journal of Political Economy, 106, 958–996.CrossRefGoogle Scholar
  37. Rahman, O., Menken, J., Foster, A., Peterson, C. E., Khan, M. N., Kuhn, R., & Gertler, P. (1999). The 1996 Matlab Health and Socioeconomic Survey: Overview and user’s guide (Unrestricted Draft Series No. DRU-2018/1-NIA). Santa Monica, CA: RAND.Google Scholar
  38. Razzaque, A. (1988). Effect of famine on fertility in an area of rural Bangladesh. Journal of Biosocial Science, 20, 287–294.CrossRefGoogle Scholar
  39. Razzaque, A., Alam, N., Wai, L., & Foster, A. (1990). Sustained effects of the 1974–5 famine on infant and child mortality in a rural area of Bangladesh. Population Studies, 44, 145–154.CrossRefGoogle Scholar
  40. Roseboom, T. J., van der Meulen, J. H. P., Osmond, C., Barker, D. J. P., Ravelli, A. C. J., & Bleker, O. P. (2001a). Adult survival after prenatal exposure to Dutch famine 1944–45. Paediatric and Perinatal Epidemiology, 16, 220–225.CrossRefGoogle Scholar
  41. Roseboom, T. J., van der Meulen, J. H. P., Ravelli, A. C., Osmond, C., Barker, D. H., & Bleker, O. P. (2001b). Effects of prenatal exposure to the Dutch famine on adult disease in later life: An overview. Twin Research, 4, 293–298.CrossRefGoogle Scholar
  42. Rosenfeld, C. S., & Roberts, R. M. (2004). Maternal diet and other factors affecting offspring sex ratio: A review. Biology of Reproduction, 71, 1063–1070.CrossRefGoogle Scholar
  43. Rosenzweig, M., & Wolpin, K. (1985). Specific experience, household structure, and intergenerational transfers: Farm family land and labor arrangements in developing countries. Quarterly Journal of Economics, 100(Suppl), 961–987.CrossRefGoogle Scholar
  44. Scott, S., Duncan, S. R., & Duncan, C. J. (1995). Infant mortality and famine: A study in historical epidemiology in Northern England. Journal of Epidemiology and Community Health, 49, 145–252.CrossRefGoogle Scholar
  45. Sen, A. (1981). Ingredients of famine analysis: Availability and entitlements. Quarterly Journal of Economics, 96, 433–464.CrossRefGoogle Scholar
  46. Stein, A. D., Zybert, P. A., & Lumey, L. H. (2004). Acute undernutrition is not associated with excess of females at birth in humans: The Dutch Hunger Winter. Proceedings of the Royal Society B, 271, S138–S141.CrossRefGoogle Scholar
  47. Stein, Z., & Susser, M. (1975). The Dutch Famine, 1944–1945, and the reproductive process. I. Effects on six indices at birth. Pediatric Research, 9, 70–76.Google Scholar
  48. Trivers, R. L., & Willard, R. E. (1973). Natural selection and the ability to vary the sex ratio of offspring. Science, 179, 90–92.CrossRefGoogle Scholar
  49. United Nations Secretariat. (2003). World population prospects: The 2000 revision. New York, NY: United Nations. Retrieved from

Copyright information

© Population Association of America 2014

Authors and Affiliations

  • Rey Hernández-Julián
    • 1
  • Hani Mansour
    • 2
  • Christina Peters
    • 1
  1. 1.Department of EconomicsMetropolitan State University of DenverDenverUSA
  2. 2.Department of EconomicsUniversity of Colorado DenverDenverUSA

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