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

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Demography

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.

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Notes

  1. As a reference, the Northridge earthquake that affected Los Angeles, California, in 1994 had a magnitude of 6.7; the devastating 2008 Sichuan earthquake in China reached 7.9; and the recent 2010 earthquake in Chile (which has no geographic overlap with the disaster examined herein) reached an 8.8 magnitude.

  2. This measure is preferred over the simple quotient between weight and gestational age because, given nonlinearities in fetal growth, this quotient is correlated with week of gestation.

  3. Given international and temporal variation in weight-by-gestational-age distributions, I use updated birth-weight curves for the Chilean population (Gonzalez et al. 2004) to calculate IUGR.

  4. Because one objective of the analysis is to examine the effect of the earthquake on gestational age, the time of the treatment is defined on the basis of estimated conception date rather than “counting back” from birth date.

  5. Because data for the entire population of Chilean births are used, significance tests are used only heuristically, implicitly invoking a super-population.

  6. Predicted values in all models identify modal categories for all covariates: women 20–29 years of age, with secondary education, with no previous live births, single, and living in urban areas.

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Acknowledgments

Funding for this project was provided by the National Science Foundation (SES-1023841). The motivation and original idea for this article emerged from conversations with Donald Treiman, to whom I am greatly indebted. I am grateful to Rajeev Dehejia, Thomas DiPrete, Ghislaine Echevarria, Catterina Ferreccio, Juho Harkonen, Eric Klinenberg, Gina Lovasi, Nicole Marwell, Catherine Monk, Patrick Sharkey, Shige Song, Julien Teitler, and two anonymous reviewers for helpful comments and suggestions. I would like to thank Danuta Raj, head of the Department of Statistics at the Ministry of Health Chile and her team for providing the Chilean birth registry data and for kindly addressing my multiple questions. I am also grateful to Manuel Dinamarca, from the Chilean National Emergency Office (ONEMI), for providing information about earthquake intensity by county. Mauricio Bucca and Emily Rauscher provided excellent research assistance.

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  1. Department of Sociology, New York University, New York, NY, USA

    Florencia Torche

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Torche, F. The Effect of Maternal Stress on Birth Outcomes: Exploiting a Natural Experiment. Demography 48, 1473–1491 (2011). https://doi.org/10.1007/s13524-011-0054-z

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