In utero exposure to economic fluctuations and birth outcomes: An analysis of the relevance of the local unemployment rate in Brazilian state capitals

Abstract

ObjectiveAnalyze if in utero exposure to economic downturns is associated with worsened birth outcomes.MethodsWe used birth records from all live singleton births in the 27 Brazilian state capitals between October 2012 and December 2016 (n = 2,952,430) and linked them to local unemployment rates according to the mother’s residence. We estimated the association between different birth outcomes and the local unemployment rate in the three trimesters before birth. We included maternal characteristics and month, year and municipality fixed effects as covariates. We also estimated the association for different groups of mothers, based on marital status, educational level, age and race.ResultsA 1 p.p. increase in the local unemployment rate in the trimester before birth is associated with 2.68% higher odds of being born with very low birthweight (< 1500 grams) (OR: 1.0268, 95% CI: 1.0006–1.0536). That result is pushed by the effect among newborns from mothers younger than 24 (OR: 1.0684, 95%CI: 1.0353–1.1024), from mothers with 11 years of schooling or less (OR: 1.0477, 95% CI: 1.0245–1.0714), and from brown or black mothers (OR: 1.0387, 95%CI: 1.0156–1.0624). The associations among children born from younger, less educated and black or brown mothers are robust to the application of a procedure to control for multiple testing, albeit the results considering the whole sample are not.ConclusionsOur study shows that there is an association between in utero exposure to higher unemployment rates during the last gestational trimester and the odds of being born with VLBW among children born from mothers younger than 24 years old, with less of 11 years of education and black or brown. These results suggest that children born from women of low socioeconomic status are more vulnerable to in utero exposure to economic downturns.

Early-life exposure to economic stress and metabolic risks in young adulthood: the children of the reunification in East Germany

“…These findings are in line with the critical period model,9 as well as with previous research showing that experiences in the early years of life can have long-term effects on health, including on metabolism 34. They also provide support for the fetal stress hypothesis, which argues that external stressors in the womb have long-term effects on development and health 35–37. Thus, our findings indicate that the postreunification economic crisis in East Germany likely exposed unborn children to extreme in utero stress resulting from their mothers’ economic distress.…”

“…Why no significant effects were found for East Germans who were exposed to the crisis later in childhood is unclear. Although the negative impact of in utero exposure to economic stress is well known,8 35 studies that compare the effects of economic stress on children who were exposed at different ages are rare. Future research should investigate possible differences by age in the effects of exposure to economic stress and seek to disentangle the corresponding mechanisms.…”

Pregnancy Outcome during the First COVID 19 Lockdown in Vienna, Austria

“…Stress, worries and anxieties during pregnancy are often associated with intrauterine growth restriction and/or preterm birth [ 44 , 45 , 46 , 47 ]. Economic crises, such as the financial crisis of 2008, also led to reduced mean birth weights in particularly affected countries such as Spain [ 48 , 49 , 50 ], Greece [ 51 ], Portugal [ 52 ], Iceland [ 53 ], Japan [ 54 ], Argentina [ 55 ], Brazil [ 56 ] and the USA [ 57 ]. Since the economic effects of the COVID 19 pandemic are comparable to those of the financial crisis in 2008, the COVID 19 pandemic and, in particular, the lockdown phases probably result in similar effects on intrauterine growth and pregnancy outcome.…”