The effect of prenatal care on birthweight: a full-information maximum likelihood approach.

Abstract:

:This paper uses a full-information maximum likelihood estimation procedure, the Discrete Factor Method, to estimate the relationship between birthweight and prenatal care. This technique controls for the potential biases surrounding both the sample selection of the pregnancy-resolution decision and the endogeneity of prenatal care. In addition, we use the actual number of prenatal care visits; other studies have normally measured prenatal care as the month care is initiated. We estimate a birthweight production function using 1993 data from the US state of Texas. The results underscore the importance of correcting for estimation problems. Specifically, a model that does not control for sample selection and endogeneity overestimates the benefit of an additional visit for women who have relatively few visits. This overestimation may indicate 'positive fetal selection,' i.e., women who did not abort may have healthier babies. Also, a model that does not control for self-selection and endogenity predicts that past 17 visits, an additional visit leads to lower birthweight, while a model that corrects for these estimation problems predicts a positive effect for additional visits. This result shows the effect of mothers with less healthy fetuses making more prenatal care visits, known as 'adverse selection' in prenatal care.

journal_name

Health Econ

journal_title

Health economics

authors

Rous JJ,Jewell RT,Brown RW

doi

10.1002/hec.801

keywords:

subject

Has Abstract

pub_date

2004-03-01 00:00:00

pages

251-64

issue

3

eissn

1057-9230

issn

1099-1050

journal_volume

13

pub_type

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