Educational gradients in the prevalence of medically assisted reproduction births in a comparative perspective.

OBJECTIVE: To study educational gradients in births after medically assisted reproduction across 5 countries with different institutional arrangements. DESIGN: We use logistic regression and compute predicted probabilities to estimate the association between education and giving birth after assisted reproduction, before and after adjustment for maternal age at delivery and marital/partnership status, using an overall sample of about 3.9 million live births in 5 countries. SETTINGS: Not applicable. PATIENTS: This study includes survey or register data containing information on births in 5 countries: N = 61,564 for Denmark, N = 37,533 for France, N = 12,889 for Spain, N = 17,097 for the United Kingdom, and N = 3,700,442 for the United States. INTERVENTION (FOR RCT) OR EXPOSURE (FOR OBSERVATIONAL STUDIES): None. MAIN OUTCOME MEASURES: The probability of a child being born after medically assisted reproduction for mothers with a university degree relative to those having less than a university degree. RESULTS: University-educated mothers are more likely to give birth after assisted reproduction compared with mothers with lower levels of education. After adjustment for socio-demographic characteristics, educational differences disappear in the United Kingdom and to some extent Spain, whereas they attenuate but persist in the other countries. The United States seems to show a larger educational gradient. CONCLUSION: The results suggest that the institutional setting around assisted reproduction may moderate the gradient. A possible explanation may be access to treatments, as the United States - the context with the lowest subsidization - seems to show larger educational gradients than other contexts. In the context of global postponement of childbearing to older ages, mothers with lower levels of socioeconomic resources might find it more difficult to fully realize their fertility intentions in countries with less generous subsidization of treatments.

Extreme Heat, Birth Outcomes, and Socioeconomic Heterogeneity.

We investigate the effect of extreme heat on birth outcomes and how this effect may vary by family socioeconomic status (SES). We create a detailed data set by linking individual-level data on approximately 4 million newborns in Spanish provincial capitals between 1990 and 2016 with precise meteorological data on the temperatures children experienced throughout their gestation. The outcomes are preterm birth, low birth weight, and very low birth weight. Socioeconomic status is assessed using parents' highest occupational level. We find that the incidence of negative birth outcomes increased for children exposed to extreme heat in early gestation. Further, the effect is concentrated mostly among children from a low socioeconomic background. Given the importance of birth outcomes for the next generation's well-being, our results highlight the potential contributions of extreme temperatures to the widening of preexisting socioeconomic inequalities. The forecasted increase in extreme climatic events makes the results of this study concerning, especially for low-SES children.

The cognitive development from childhood to adolescence of low birthweight children born after medically assisted reproduction-a UK longitudinal cohort study.

BACKGROUND: Previous research has documented that children conceived through medically assisted reproduction (MAR) are at increased risk of poor birth outcomes, such as low birthweight (LBW), which are risk factors for stunted longer-term cognitive development. However, parents who undergo MAR to conceive have, on average, advantaged socioeconomic backgrounds which could compensate for the negative effects of being born LBW. Previous studies have not analysed whether the negative effects of LBW are attenuated among MAR conceived children. METHODS: We draw on the UK Millennium Cohort Study (sweeps 1-6) which contains a sub-sample of (N = 396) MAR-conceived children. The dependent variable measures cognitive ability at around ages 3, 5, 7, 11 and 14. We examine the cognitive development of four groups of children: MAR-conceived low birthweight (MAR LBW); MAR-conceived non-low birthweight (MAR NLBW); naturally conceived low birthweight (NC LBW); naturally conceived non-low birthweight (NC NLBW). We estimate the two following linear regression models for each sweep: (i) a baseline model to examine the unadjusted association between cognitive development and low birthweight by mode of conception; and (ii) a model adjusted by socio-demographic family characteristics. RESULTS: In baseline models, MAR LBW children [age 3: ß = 0.021, 95% confidence interval (CI): -0.198, 0.241; age 5: ß = 0.21, 95% CI: 0.009, 0.418; age 7: ß = 0.163, 95% CI: -0.148, 0.474; age 11: ß = 0.003, 95% CI: -0.318, 0.325; age 14: ß = 0.156, 95% CI: -0.205, 0.517], on average perform similarly in cognitive ability relative to NC NLBW at all ages, and display higher cognitive scores than NC LBW children until age 7. When we account for family characteristics, differences are largely attenuated and become close to zero at age 14. CONCLUSIONS: Despite the higher incidence of LBW among MAR compared with NC children, they do not seem to experience any disadvantage in their cognitive development compared with naturally conceived children. This finding is likely explained by the fact that, on average, MAR children are born to socioeconomically advantaged parents.

Soccer Scores, Short-Term Mood and Fertility.

Previous research has shown that seemingly irrelevant events such as unexpected outcomes in sporting events can affect mood and have relevant consequences for episodes of crime and violence, investing behavior and political preferences. In this article, we test whether mood shocks associated with unexpected results in soccer matches in Spain affect fertility. We use data on betting odds and actual scores to define mood shocks and link them to births by month and province in Spain, between 2001 and 2015. We find that unexpected losses of local teams lead to a small decrease in the number of births nine months thereafter. The effect is larger for more unexpected losses, in those provinces with the largest amount of support for the local team and robust to a number of placebo tests. We argue that these results are consistent with the gain-loss asymmetry predicted by prospect theory.

Social inequality and the risk of living in a nursing home: implications for the COVID-19 pandemic.

Across EU countries, all available evidence suggests that the number of deaths linked to COVID-19 among those living in nursing homes has been extremely high. However, it is largely unknown to what extent income and education affect the probability of being a nursing home resident. If the probability of residing in a nursing home is stratified by socio-economic status, under the current COVID-19 pandemic socio-economic inequality in the probability of living in a nursing home could contribute to enlarge socio-economic inequalities in the risk of mortality with COVID-19. In this article, we investigate whether there are income and educational differences in the likelihood of being a resident in a nursing home across 12 European countries. We use SHARE data (waves 5-7) and compute logistic regression models for rare events. We find that low-educated individuals and those having household income below the national median are more likely to live in a nursing home. This general pattern holds across all the European countries considered. However, there is considerable uncertainty in our estimates due to a small sample size, and firm conclusions on how the effect of socio-economic characteristics varies across countries cannot be drawn. Still, there is some indication that educational and income differences are the largest in the Scandinavian countries (Denmark and Sweden) and the Netherlands, while the smallest ones are found in Italy, with the remaining countries laying in between.

The cognitive development from childhood to adolescence of low birthweight children born after medically assisted reproduction-a UK longitudinal cohort study.

BACKGROUND: Previous research has documented that children conceived through medically assisted reproduction (MAR) are at increased risk of poor birth outcomes, such as low birthweight (LBW), which are risk factors for stunted longer-term cognitive development. However, parents who undergo MAR to conceive have, on average, advantaged socioeconomic backgrounds which could compensate for the negative effects of being born LBW. Previous studies have not analysed whether the negative effects of LBW are attenuated among MAR conceived children. METHODS: We draw on the UK Millennium Cohort Study (sweeps 1-6) which contains a sub-sample of (N = 396) MAR-conceived children. The dependent variable measures cognitive ability at around ages 3, 5, 7, 11 and 14. We examine the cognitive development of four groups of children: MAR-conceived low birthweight (MAR LBW); MAR-conceived non-low birthweight (MAR NLBW); naturally conceived low birthweight (NC LBW); naturally conceived non-low birthweight (NC NLBW). We estimate the two following linear regression models for each sweep: (i) a baseline model to examine the unadjusted association between cognitive development and low birthweight by mode of conception; and (ii) a model adjusted by socio-demographic family characteristics. RESULTS: In baseline models, MAR LBW children [age 3: ß = 0.021, 95% confidence interval (CI): -0.198, 0.241; age 5: ß = 0.21, 95% CI: 0.009, 0.418; age 7: ß = 0.163, 95% CI: -0.148, 0.474; age 11: ß = 0.003, 95% CI: -0.318, 0.325; age 14: ß = 0.156, 95% CI: -0.205, 0.517], on average perform similarly in cognitive ability relative to NC NLBW at all ages, and display higher cognitive scores than NC LBW children until age 7. When we account for family characteristics, differences are largely attenuated and become close to zero at age 14. CONCLUSIONS: Despite the higher incidence of LBW among MAR compared with NC children, they do not seem to experience any disadvantage in their cognitive development compared with naturally conceived children. This finding is likely explained by the fact that, on average, MAR children are born to socioeconomically advantaged parents.