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Long-term effect of in utero conditions on maternal survival later in life: evidence from Sub-Saharan Africa

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  • Alison B. Comfort

    (Abt Associates Inc.)

Abstract

Sub-Saharan African countries have some of the world’s highest rates of maternal mortality. Most research on maternal mortality focuses on factors during pregnancy and delivery. However, consistent with the fetal programming hypothesis, a woman’s maternal survival may also be related to conditions she experienced while in utero. I examine this hypothesis in 14 African countries by relating rainfall when a woman was in utero with her maternal survival later in her life. High levels of rainfall, representing better in utero conditions, decrease the probability of maternal death by 1.1 percentage points, a 58 % decrease from a mean of 1.9 %. Higher rainfall while in utero reduces the probability of anemia during pregnancy, a risk factor for postpartum hemorrhage. Another plausible pathway is through a reduction in body mass index, a predictor of pregnancy-induced hypertension. Improving conditions for pregnant women will have inter-generational effects, benefiting pregnant women today and improving their daughters’ maternal survival.

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  • Alison B. Comfort, 2016. "Long-term effect of in utero conditions on maternal survival later in life: evidence from Sub-Saharan Africa," Journal of Population Economics, Springer;European Society for Population Economics, vol. 29(2), pages 493-527, April.
    • Handle: RePEc:spr:jopoec:v:29:y:2016:i:2:d:10.1007_s00148-015-0581-9
    DOI: 10.1007/s00148-015-0581-9
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    Cited by:

    1. Wang-Sheng Lee & Ben G. Li, 2019. "Extreme Weather and Long-term Health: Evidence from Two Millennia of Chinese Elites," CEH Discussion Papers 09, Centre for Economic History, Research School of Economics, Australian National University.
    2. Johabed G. Olvera & Julio A. Ramos Pastrana, 2024. "Enhancing information to improve outcomes: the impact of home visiting programs on maternal health," Journal of Population Economics, Springer;European Society for Population Economics, vol. 37(4), pages 1-36, December.
    3. Hyland, Marie & Russ, Jason, 2019. "Water as destiny – The long-term impacts of drought in sub-Saharan Africa," World Development, Elsevier, vol. 115(C), pages 30-45.
    4. M. Perez-Alvarez & M. Favara, 2023. "Children having children: early motherhood and offspring human capital in India," Journal of Population Economics, Springer;European Society for Population Economics, vol. 36(3), pages 1573-1606, July.
    5. Lee, Wang-Sheng & Li, Ben G., 2021. "Extreme weather and mortality: Evidence from two millennia of Chinese elites," Journal of Health Economics, Elsevier, vol. 76(C).
    6. Farris, Jarrad G. & Jin, Songqing & Maredia, Mywish K. & Porter, Maria, 2018. "Assessing Heterogeneity in the Child Growth Impacts of In-Utero Rainfall Shocks in Rural Rwanda," 2018 Annual Meeting, August 5-7, Washington, D.C. 274230, Agricultural and Applied Economics Association.
    7. Gokben Aydilek & Deniz Karaoğlan, 2024. "The effect of prenatal exposure to Ramadan on human capital: evidence from Turkey," Journal of Population Economics, Springer;European Society for Population Economics, vol. 37(3), pages 1-35, September.
    8. Xi Qiao & Bilinda Straight & Duy Ngo & Charles E. Hilton & Charles Owuor Olungah & Amy Naugle & Claudia Lalancette & Belinda L. Needham, 2024. "Severe drought exposure in utero associates to children’s epigenetic age acceleration in a global climate change hot spot," Nature Communications, Nature, vol. 15(1), pages 1-9, December.
    9. Olukorede Abiona, 2017. "Adverse Effects of Early Life Extreme Precipitation Shocks on Short-term Health and Adulthood Welfare Outcomes," Review of Development Economics, Wiley Blackwell, vol. 21(4), pages 1229-1254, November.

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    More about this item

    Keywords

    Fetal programming; In utero conditions; Maternal mortality; Sub-Saharan Africa;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development

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