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Maternal Bed Rest and Infant Health

Author

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  • Christine Piette Durrance

    (Department of Public Policy, University of North Carolina at Chapel Hill)

  • Melanie Guldi

    (Department of Economics, University of Central Florida)

Abstract

Negative shocks to early child health influence both short- and long-run outcomes. Interventions prior to birth, rather than early in childhood, may reduce the probability or the severity of the shock and may be relatively cost effective. One such intervention, bed rest during pregnancy, is frequently prescribed to reduce the likelihood of preterm birth. Premature infants experience worse average initial infant health than full-term infants and these differences may persist into adulthood without mediation. Recent medical literature on the efficacy of bed rest is mixed, but tilts towards a negative or zero relationship between bed rest and infant health, suggesting that this intervention does not improve initial health status. This is not surprising given the difficulty of navigating a crucial threat to identification: conditions leading to bed rest recommendations are correlated with infant health. We investigate this question using Pregnancy Risk Assessment Monitoring System (PRAMS) data. Among women who experience a medical issue during pregnancy, we compare outcomes of infants born to mothers who are observationally similar yet differ in whether they are recommended bed rest. Using OLS and matching methods, we find a positive relationship between bed rest and the likelihood of low birth weight and prematurity (consistent with prior medical literature). Yet our results also show that bed rest decreases the incidence of very low birth weight (at least −15.4 percent), very premature outcomes (at least −7.7 percent), and a reduction for infant death. We provide additional evidence that suggests bed rest shifts initial health status upward. Our back-of-the-envelope calculations suggest that when accounting for cost savings over both the short and the long run, bed rest may be more cost-effective treatment than post-birth interventions.

Suggested Citation

  • Christine Piette Durrance & Melanie Guldi, 2015. "Maternal Bed Rest and Infant Health," American Journal of Health Economics, University of Chicago Press, vol. 1(3), pages 345-373, Summer.
  • Handle: RePEc:ucp:amjhec:v:1:y:2015:i:3:p:345-373
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    References listed on IDEAS

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    1. Heather Royer, 2009. "Separated at Girth: US Twin Estimates of the Effects of Birth Weight," American Economic Journal: Applied Economics, American Economic Association, vol. 1(1), pages 49-85, January.
    2. Cai, Lixin, 2010. "The relationship between health and labour force participation: Evidence from a panel data simultaneous equation model," Labour Economics, Elsevier, vol. 17(1), pages 77-90, January.
    3. Philip Oreopoulos & Mark Stabile & Randy Walld & Leslie L. Roos, 2008. "Short-, Medium-, and Long-Term Consequences of Poor Infant Health: An Analysis Using Siblings and Twins," Journal of Human Resources, University of Wisconsin Press, vol. 43(1).
    4. Almond, Douglas & Currie, Janet, 2011. "Human Capital Development before Age Five," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 15, pages 1315-1486, Elsevier.
    5. Alberto Abadie & Guido W. Imbens, 2006. "Large Sample Properties of Matching Estimators for Average Treatment Effects," Econometrica, Econometric Society, vol. 74(1), pages 235-267, January.
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    Cited by:

    1. Hope Corman & Dhaval Dave & Nancy E. Reichman, 2018. "Evolution of the Infant Health Production Function," Southern Economic Journal, John Wiley & Sons, vol. 85(1), pages 6-47, July.
    2. Melanie E. Guldi & Amelia Hawkins & Jeffrey Hemmeter & Lucie Schmidt, 2018. "Supplemental Security Income and Child Outcomes: Evidence from Birth Weight Eligibility Cutoffs," Department of Economics Working Papers 2018-12, Department of Economics, Williams College.
    3. Saavedra, Martin, 2020. "Birth weight and infant health for multiple births," Journal of Health Economics, Elsevier, vol. 69(C).

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    More about this item

    Keywords

    early child health; bed rest; premature infants; Pregnancy Risk Assessment Monitoring System;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General

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