Although difficulty conceiving a child has long been a major medical and social preoccupation, it has not been considered as a predictor of long-term outcomes in children ultimately conceived. This is consistent with a broader gap in knowledge regarding the consequences of parental health for educational performance in offspring. Here we address that omission, asking how resolved parental infertility relates to children’s academic achievement. In a sample of all Swedish births between 1988 and 1995, we find that involuntary childlessness prior to either a first or a second birth is associated with lower academic achievement (both test scores and GPA) in children at age 16, even if the period of infertility was prior to a sibling’s birth rather than the child’s own. Our results support a conceptualization of infertility as a cumulative physical and social experience with effects extending well beyond the point at which a child is born, and emphasize the need to better understand how specific parental health conditions constrain children’s educational outcomes.
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The term “infertility” is used here as per the medical definition, describing a failure to attain a live birth despite consistent exposure to pregnancy risk (Mascarenhas et al. 2013; WHO 1991). Medical infertility is thus largely synonymous with infecundity; find more on this point in the Methods and Analysis section.
Our measure of infertility is based on the time to a live birth. We unfortunately lack information on whether mothers miscarried during that period unless the miscarriage was late enough in a pregnancy to qualify as a stillbirth or otherwise require hospitalization. Cases of stillbirth were very few and were omitted from the sample.
Grades range from A to F, with E as the lowest passing grade. A top score (“pass with special distinction”) is equivalent to 20 points, and a minimal passing score is equivalent to 10 points.
Test scores in Swedish and English are reported as an ordinal measure (Fail, Pass, Pass with distinction, Pass with high distinction). Running linear probability models using “Pass with high distinction” in Swedish language as the outcome, we obtain results similar to those presented for math. No results are found for English.
The mean number of children in the full registry sample over the time frame defined here was 1.72. Families with only one child constituted 43 % of the full sample; families with two children constituted 44 %; with three children, 11 %; with four or more children, 1.6 %.
Although paternal health is also an important consideration in understanding causes of infertility, paternal health behaviors (such as smoking) were not recorded in the MBR.
The measurement of demographic controls at age 14 and test scores at age 16 reflects data availability rather than an effort to lag covariates. Lifetime earnings are calculated as per Lindahl et al. (2015).
Additional specifications included using indicators for each year of infertility, each two years of infertility, and including C as a continuous measure with higher-order terms. Results were substantively the same as those presented using the two-category specification of C. Frequencies of primary and secondary infertility for zero through five or more years are presented in Table S5, Online Resource 1.
Couples who experienced five or more years of infertility are rare, and couples who experienced five or more years of infertility before both a first and a second birth are extremely rare (<0.1 % of the sample). Coefficients on the remaining interactions between C i and S i were in the same direction as for the interaction presented but with volatility in magnitudes, given the dramatically declining cell sizes.
Sexually transmitted infections (STIs) could be a particularly useful set of controls in this case, given the higher rates of STIs in Scandinavian countries relative to other Western European nations (European Centre for Disease Prevention and Control 2011). In addition to the medical consequences of STIs for fertility, STI prevalence may be indicative of country-specific cultural norms that also reflect other aspects of lifestyle relevant for parenting.
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The authors acknowledge funding from the Centre for Economic Demography and from the Cornell Population Center, and additionally thank participants at the seminars in the Centre for Economic Demography and the Cornell Population Center, who provided invaluable feedback on this manuscript.
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Branigan, A.R., Helgertz, J. Resolved Parental Infertility and Children’s Educational Achievement. Demography 54, 911–931 (2017). https://doi.org/10.1007/s13524-017-0573-3
- Parental health