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1.
Proc Natl Acad Sci U S A ; 120(49): e2311573120, 2023 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-38011548

RESUMEN

In utero exposure to COVID-19 infection may lead to large intergenerational health effects. The impact of infection exposure has likely evolved since the onset of the pandemic as new variants emerge, immunity from prior infection increases, vaccines become available, and vaccine hesitancy persists, such that when infection is experienced is as important as whether it is experienced. We examine the changing impact of COVID-19 infection on preterm birth and the moderating role of vaccination. We offer the first plausibly causal estimate of the impact of maternal COVID-19 infection by using population data with no selectivity, universal information on maternal COVID-19 infection, and linked sibling data. We then assess change in this impact from 2020 to 2023 and evaluate the protective role of COVID-19 vaccination on infant health. We find a substantial adverse effect of prenatal COVID-19 infection on the probability of preterm birth. The impact was large during the first 2 y of the pandemic but had fully disappeared by 2022. The harmful impact of COVID-19 infection disappeared almost a year earlier in zip codes with high vaccination rates, suggesting that vaccines might have prevented thousands of preterm births. The findings highlight the need to monitor the changing consequences of emerging infectious diseases over time and the importance of mitigation strategies to reduce the burden of infection on vulnerable populations.


Asunto(s)
COVID-19 , Nacimiento Prematuro , Recién Nacido , Lactante , Femenino , Embarazo , Humanos , Salud del Lactante , Vacunas contra la COVID-19 , COVID-19/prevención & control , Vacunación
2.
Demography ; 59(6): 2025-2051, 2022 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-36326022

RESUMEN

The COVID-19 pandemic has taken a large toll on population health and well-being. We examine the consequences of prenatal exposure for infant health, through which the pandemic may have lasting intergenerational effects. We examine multiple pathways by which the pandemic shaped birth outcomes and socioeconomic disparities in these consequences. Analysis of more than 3.5 million birth records in California with universal information on COVID infection among persons giving birth at the time of delivery reveals deep inequalities in infection by education, race/ethnicity, and place-based socioeconomic disadvantage. COVID infection during pregnancy, in turn, predicts a large increase in the probability of preterm birth, by approximately one third. At the population level, a surprising reduction in preterm births during the first months of the pandemic was followed by an increase in preterm births during the surge in COVID infections in the winter of 2021. Whereas the early-pandemic reduction in preterm births benefited primarily highly educated mothers, the increase in preterm births during the winter infection surge was entirely concentrated among mothers with low levels of schooling. The COVID-19 pandemic is expected to exacerbate U.S. inequality in multiple ways. Our findings highlight a particularly enduring pathway: the long-term legacy of prenatal exposure to an unequal pandemic environment.


Asunto(s)
COVID-19 , Nacimiento Prematuro , Recién Nacido , Embarazo , Humanos , Femenino , COVID-19/epidemiología , Pandemias , Salud del Lactante , Nacimiento Prematuro/epidemiología , Madres
3.
Womens Health Issues ; 32(3): 226-234, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35016841

RESUMEN

OBJECTIVES: Medicaid expansion under the Affordable Care Act (ACA) improved access to reproductive health care for low-income women and birthing people who were previously ineligible for Medicaid. We aimed to evaluate if the expansion affected the risk of having a short interpregnancy interval (IPI), a preventable risk factor for adverse pregnancy outcomes. METHODS: We evaluated parous singleton births to mothers aged 19 or older from U.S. birth certificate data 2009-2018. We estimated the effect of residing in a state that expanded Medicaid access (expansion status determined at 60 days after the prior live birth) on the risk of having a short IPI (<12 months) using difference-in-differences (DID) methods in linear probability models. We stratified the analyses by maternal characteristics and county-level reproductive health care access. RESULTS: Overall risk of short IPI was 14.9% in expansion states and 16.3% in non-expansion states. The expansion was not associated with a significant change in risk of having a short IPI (adjusted mean percentage point change 1.24 [-1.64, 4.12]). Stratified results also did not provide support for an association. CONCLUSIONS: ACA Medicaid expansion did not have an impact on risk of short IPI. Preventing short IPI may require more comprehensive policy interventions in addition to health care access.


Asunto(s)
Intervalo entre Nacimientos , Medicaid , Certificado de Nacimiento , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Cobertura del Seguro , Patient Protection and Affordable Care Act , Embarazo , Estados Unidos
4.
Sociol Compass ; 16(4)2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38895138

RESUMEN

Disruptive events have significant consequences for the individuals and families who experience them, but these effects do not occur equally across the population. While some groups are strongly affected, others experience few consequences. We review recent findings on inequality in the effects of disruptive events. We consider heterogeneity based on socioeconomic resources, race/ethnicity, the likelihood of experiencing disruption, and contextual factors such as the normativity of the event in particular social settings. We focus on micro-level events affecting specific individuals and families, including divorce, job loss, home loss and eviction, health shocks and deaths, and violence and incarceration, but also refer to macro-level events such as recession and natural disasters. We describe patterns of variation that suggest a process of resource disparities and cumulative disadvantage versus those that reflect the impact of non-normative and unexpected shocks. Finally, we review methodological considerations when examining variation in the effect of disruptive events.

5.
Am J Epidemiol ; 188(1): 24-33, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30358825

RESUMEN

Unauthorized immigration is one of the most contentious policy issues in the United States. In an attempt to curb unauthorized migration, many states have considered restrictive laws intended to make life so difficult for unauthorized immigrants that they would choose to leave the country. Arizona's Senate Bill 1070, enacted in 2010, was a pioneering example of these efforts. Using population-level natality data and causal inference methods, we examined the effect of SB1070 on infants exposed before birth in Arizona. Prenatal exposure to the bill resulted in lower birth weight among Latina immigrant women, but not among US-born white, black, or Latina women. The decline in birth weight resulted from exposure to the bill being signed into law, rather than from its (limited) implementation. The findings indicate that the threat of a punitive law, even in the absence of implementation, can have a harmful effect on the birth outcomes of the next generation.


Asunto(s)
Peso al Nacer , Emigración e Inmigración/legislación & jurisprudencia , Inmigrantes Indocumentados/legislación & jurisprudencia , Inmigrantes Indocumentados/estadística & datos numéricos , Arizona/epidemiología , Femenino , Humanos , Embarazo , Estados Unidos/epidemiología
6.
Demography ; 55(5): 1611-1639, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30105648

RESUMEN

Exposure to environmental stressors is highly prevalent and unequally distributed along socioeconomic lines and may have enduring negative consequences, even when experienced before birth. Yet, estimating the consequences of prenatal stress on children's outcomes is complicated by the issue of confounding (i.e., unobserved factors correlated with stress exposure and with children's outcomes). I combine a natural experiment-a strong earthquake in Chile-with a panel survey to capture the effect of prenatal exposure on acute stress and children's cognitive ability. I find that stress exposure in early pregnancy has no effect on children's cognition among middle-class families, but it has a strong negative influence among disadvantaged families. I then examine possible pathways accounting for the socioeconomic stratification in the effect of stress, including differential exposure across socioeconomic status, differential sensitivity, and parental responses. Findings suggest that the interaction between prenatal exposures and socioeconomic advantage provides a powerful mechanism for the intergenerational transmission of disadvantage.


Asunto(s)
Desarrollo Infantil , Cognición , Desastres , Terremotos , Efectos Tardíos de la Exposición Prenatal/psicología , Enfermedad Aguda , Niño , Chile , Factores de Confusión Epidemiológicos , Femenino , Humanos , Masculino , Padres/psicología , Embarazo , Trimestres del Embarazo , Factores Socioeconómicos
7.
Sociol Methods Res ; 46(1): 103-124, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28025587

RESUMEN

Does participation in one wave of a survey have an effect on respondents' answers to questions in subsequent waves? In this article, we investigate the presence and magnitude of "panel conditioning" effects in one of the most frequently used data sets in the social sciences: the General Social Survey (GSS). Using longitudinal records from the 2006, 2008, and 2010 surveys, we find evidence that at least some GSS items suffer from this form of bias. To rule out the possibility of contamination due to selective attrition and/or unobserved heterogeneity, we strategically exploit a series of between-person comparisons across time-in-survey groups. This methodology, which can be implemented whenever researchers have access to at least three waves of rotating panel data, is described in some detail so as to facilitate future applications in data sets with similar design elements.

8.
Demography ; 53(6): 1883-1904, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27844397

RESUMEN

Theory and empirical evidence suggest that parents allocate their investments unequally among their children, thus inducing within-family inequality. We investigate whether parents reinforce or compensate for initial ability differences between their children as well as whether these parental responses vary by family socioeconomic status (SES). Using the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) and a twin fixed-effects approach to address unobserved heterogeneity, we find that parental responses to early ability differences between their children do vary by family SES. Contrary to prior findings, we find that advantaged parents provide more cognitive stimulation to higher-ability children, and lower-class parents do not respond to ability differences. No analogous stratification in parental responses to birth weight is found, suggesting that parents' responses vary across domains of child endowments. The reinforcing responses to early ability by high-SES parents do not, however, led to increases in ability differences among children because parental responses have little effect on children's later cognitive performance in this twin sample.


Asunto(s)
Desarrollo Infantil , Padres/psicología , Clase Social , Peso al Nacer , Preescolar , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Relaciones Padres-Hijo , Gemelos
9.
Demography ; 51(3): 835-56, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24811134

RESUMEN

Exchange of racial for educational status has been documented for black/white marriages in the United States. Exchange may be an idiosyncratic feature of U.S. society, resulting from unusually strong racial boundaries historically developed there. We examine status exchange across racial lines in Brazil. In contrast to the United States, Brazil features greater fluidity of racial boundaries and a middle tier of "brown" individuals. If exchange is contingent on strong racial boundaries, it should be weak or non-existent in Brazilian society. Contrary to this expectation, we find strong evidence of status exchange. However, this pattern results from a generalized penalty for darkness, which induces a negative association between higher education and marrying darker spouses ("market exchange") rather than from a direct trading of resources by partners ("dyadic exchange"). The substantive and methodological distinction between market and dyadic exchange helps clarify and integrate prior findings in the status exchange literature.


Asunto(s)
Negro o Afroamericano , Matrimonio/etnología , Población Blanca , Adulto , Brasil , Escolaridad , Femenino , Humanos , Masculino , Factores Socioeconómicos
11.
Hum Reprod ; 27(2): 558-67, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22157912

RESUMEN

BACKGROUND: Previous research suggests that maternal exposure to acute stress has a negative impact on the duration of pregnancy, and that this effect may vary by the time of exposure. It has also been proposed that stress exposure reduces the ratio of male-to-female births. To date, no study has jointly examined both outcomes, although they may be strongly related. Using population-level data with no selectivity, we jointly study the sex-specific effect of stress on the duration of pregnancy and the observed sex ratio among pregnant women exposed to a major earthquake in Chile. METHODS: In a quasi-experimental design, women exposed to the earthquake in different months of gestation were compared with women pregnant 1 year earlier. Estimates from a comparison group of pregnant women living in areas not affected by the earthquake were also examined to rule out confounding trends. Regression models were used to measure the impact of earthquake exposure on gestational age and preterm birth by sex across month of gestation. A counterfactual simulation was implemented to assess the effect of the earthquake on the secondary sex ratio accounting for the differential impact of stress on gestational age by sex. RESULTS: Earthquake exposure in Months 2 and 3 of gestation resulted in a significant decline in gestational age and increase in preterm delivery. Effects varied by sex, and were much larger for female than male pregnancies. Among females, the probability of preterm birth increased by 0.038 [95% confidence interval (CI): 0.005, 0.072] in Month 2 and by 0.039 (95% CI: 0.002, 0.075) in Month 3. Comparable increases for males were insignificant at the conventional P < 0.05 level. After accounting for the sex-specific impact on gestational age, a decline in the male-to-female ratio in Month 3 of exposure was detected [-0.058 (95% CI: -0.113, -0.003)]. CONCLUSIONS: Maternal exposure to an exogenous stressor early but not late in the pregnancy affects gestational age and the probability of preterm birth. This effect is much stronger in females than males. Stress exposure in early pregnancy may also contribute to a decline in the ratio of male-to-female live births in exposed cohorts.


Asunto(s)
Desastres , Complicaciones del Embarazo/fisiopatología , Primer Trimestre del Embarazo , Nacimiento Prematuro/etiología , Nacimiento Prematuro/psicología , Estrés Fisiológico , Estrés Psicológico/fisiopatología , Adolescente , Adulto , Certificado de Nacimiento , Chile/epidemiología , Estudios de Cohortes , Terremotos , Femenino , Edad Gestacional , Humanos , Recién Nacido , Masculino , Embarazo , Tercer Trimestre del Embarazo , Nacimiento Prematuro/epidemiología , Caracteres Sexuales , Distribución por Sexo , Adulto Joven
12.
Demography ; 48(4): 1473-91, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21870187

RESUMEN

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.


Asunto(s)
Desastres , Terremotos , Exposición Materna/efectos adversos , Resultado del Embarazo , Estrés Psicológico , Peso al Nacer , Chile/epidemiología , Femenino , Retardo del Crecimiento Fetal/epidemiología , Edad Gestacional , Humanos , Embarazo , Trimestres del Embarazo , Nacimiento Prematuro/epidemiología
13.
Int J Epidemiol ; 40(4): 1008-18, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21362701

RESUMEN

BACKGROUND: Intra-uterine growth is a powerful predictor of infant mortality and of health, developmental and socioeconomic outcomes in adulthood. The question about whether this relationship is causal rather than driven by unobserved characteristics of low-weight infants is, however, still open. We use twin models to examine the hypothesis that in utero growth has a detrimental impact on cognitive development in childhood. METHODS: We merge birth registry information on birthweight with standardized Math and Spanish test scores for all fourth graders in Chile to create a prospective data set. Twin fixed-effects models are used to estimate the causal effect of intra-uterine growth on test scores. Fixed-effect estimates are compared with traditional regression results in a cross-section of births to gauge the omitted variable bias emerging from unobserved genetic, maternal and pregnancy-related factors in cross-sectional models. RESULTS: Birthweight differences within twin pairs have a substantial effect on test scores. A 400-g increase in birthweight results in a 15% standard deviation increase in Math scores. The effect is larger among (estimated) monozygotic than dizygotic pairs, reaching >20% standard deviation. The effect varies across family socioeconomic status. It is strong among disadvantaged families but it nearly disappears among advantaged ones. CONCLUSION: Scarcity of uterine resources resulting in intra-uterine growth restriction has a detrimental effect on cognitive development in childhood. This effect interacts with family socioeconomic status (SES), so that low-SES families reinforce the effect of low birthweight and high-SES families fully compensate for it. Findings are particularly relevant in the developing world, where intra-uterine growth restriction is the main determinant of low birthweight.


Asunto(s)
Peso al Nacer/fisiología , Cognición/fisiología , Gemelos Dicigóticos/psicología , Gemelos Dicigóticos/estadística & datos numéricos , Gemelos Monocigóticos/psicología , Gemelos Monocigóticos/estadística & datos numéricos , Adolescente , Adulto , Niño , Chile , Evaluación Educacional , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Lenguaje , Estudios Longitudinales , Masculino , Edad Materna , Matemática/educación , Embarazo , Sistema de Registros , Análisis de Regresión , Factores Socioeconómicos , Adulto Joven
14.
Ann Epidemiol ; 20(11): 818-26, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20933189

RESUMEN

PURPOSE: Research suggests a relationship between birth weight and season of birth, but findings vary across countries and underlying factors are not well understood. We examine the seasonality of birth weight and explore alternative hypotheses for its etiology-exposure to environmental factors and varying socioeconomic composition of mothers-in Chile. METHODS: Birth weight of approximately 5 million Chilean singleton live births 37 of 41 weeks of gestation between 1987 and 2007 were analyzed for seasonality by using regression models with month dummies and parametric sinusoidal specifications. Multivariate models with socioeconomic covariates and interactions across geographic regions examine potential factors accounting for seasonal variation. RESULTS: Marked 12-month and 6-month periodic cycles were found. The amplitude and phase of the seasonal variation change across geographic regions. In the low-latitude northern region, there is a spring peak and a fall nadir, while in middle-latitude colder regions, a bimodal periodicity emerges with peaks in spring and fall, a pronounced winter nadir, and smaller nadir in the summer. Socioeconomic composition of mothers is found to vary with annual periodicity, but it does not account for the seasonality in birth weight. CONCLUSIONS: Environmental factors rather than the socioeconomic composition of mothers likely account for seasonal variation in birth weight. The change in periodicity of birth weight across latitudes is consistent with a beneficial exposure to sunlight both early and late in the pregnancy, and a detrimental late exposure to cold temperatures only in areas with low winter temperatures.


Asunto(s)
Peso al Nacer , Ambiente , Bienestar Materno , Atención Perinatal , Estaciones del Año , Chile , Intervalos de Confianza , Humanos , Modelos Lineales , Análisis Multivariante , Factores de Riesgo , Factores Socioeconómicos , Factores de Tiempo
15.
Demography ; 47(2): 481-502, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20608107

RESUMEN

Educational assortative mating and economic inequality are likely to be endogenously determined, but very little research exists on their empirical association. Using census data and log-linear and log-multiplicative methods, I compare the patterns of educational assortative mating in Brazil, Chile, and Mexico, and explore the association between marital sorting and earnings inequality across countries. The analysis finds substantial variation in the strength of specific barriers to educational intermarriage between countries, and a close association between these barriers and the earnings gaps across educational categories within countries. This finding suggests an isomorphism between assortative mating and economic inequality. Furthermore, educational marital sorting is remarkably symmetric across gender in spite of the different resources that men and women bring to the union. This study highlights the limitations of using single aggregate measures of spousal educational resemblance (such as the correlation coefficient between spouses' schooling) to capture variation in assortative mating and its relationship with socioeconomic inequality.


Asunto(s)
Escolaridad , Matrimonio , Clase Social , Adolescente , Adulto , Brasil , Chile , Femenino , Humanos , Modelos Lineales , Masculino , Matrimonio/estadística & datos numéricos , México , Persona de Mediana Edad , Análisis Multivariante
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