Child Health and the Impact of Maternal Fasting

儿童健康和母亲禁食的影响

• 批准号: 9233781
• 负责人: David A Jaeger
• 金额: $ 6.45万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-27 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9233781
• 关键词: Adult; Almond Nut; Arabs; Behavior; Birth; Birth Records; Birth Weight; Calendar; Child; Child Development; Child health care; Childhood; Coronary; Costs and Benefits; Country; Data; Data Set; Date of birth; Death Records; Diet; Disabled Persons; Disease; Education; Employee Strikes; Event; Exposure to; Family; Famines; Fasting; Fetal Mortality Statistics; Fetus; German population; Germany; Gestational Age; Health; Health education; Heterogeneity; Impairment; Income; Individual; Intervention; Life; Link; Literature; Long-Term Effects; Low Birth Weight Infant; Mothers; Multiple Birth Offspring; Muslim population group; Muslim religion; Natural experiment; Neonatal Mortality; Newborn Infant; Non-Insulin-Dependent Diabetes Mellitus; Nutritional; Outcome; Patient Self-Report; Placebos; Policies; Policy Maker; Population; Pregnancy; Pregnant Women; Prenatal Nutrition; Probability; Productivity; Religion; Religion and Spirituality; Research; Research Design; Risk; Ritual compulsion; Sampling; Shock; Siblings; Testing; Time; Translating; Variant; Weight Gain; Woman; cohort; experience; experimental study; improved; in utero; intergenerational; mortality; mother nutrition; nutrition; offspring; pregnant; prenatal exposure; public health relevance; socioeconomics; survivorship; transmission process

 DESCRIPTION (provided by applicant): Low birth weight, which is partly determined through poor in utero nutrition, has been shown to be associated with adverse health and socioeconomic outcomes, both in childhood and later in life. Prior research has used plausibly exogenous events, such as famines, to identify a causal link between in utero nourishment and birth weight. These estimates of the effect of nutrition on birth weight suffer, however, from survivorship bias. The proposed research exploits a natural experiment provided by the mild nutritional shock of maternal fasting during the Islamic holy month of Ramadan. The idiosyncratic variation in the timing of Ramadan allows us to plausibly estimate causal effects of an intent-to-treat effect for children who in utero were potentially exposed to maternal fasting. Given the significant short- term and long-term effects of low birth weight on child development and adult health, the findings of the proposed research have considerable value for policy makers weighing the costs and benefits of policy interventions related to fasting and dieting during pregnancy. The study will use population birth and death records from Germany, a country with a Muslim population of around 4 million, for the years from 1980 to 2013. We will have data on approximately 1.7 million births to Muslim mothers during this sample period. The long observation period allows us to net out all seasonality from the data, as Ramadan occurs during all twelve months of the Gregorian calendar during a 33-year period. Moreover, unlike previous studies the German data allow us to definitively identify Muslim and non-Muslim women and also provide exact information on birth weight, dates of birth, and a wide array of covariates. A unique feature of the data allows us to identify multiple births to the same mother and control for unobserved between-family heterogeneity and to exploit variation in potential fasting behavior across siblings. We will also be able to examine intergenerational effects of in utero exposure to potential fasting, as the birth records also contain exact information about the mother's birth date. Lastly, by linking the birth records to death records, we will be used to assess the effect of fasting on neonatal mortality. By using such a large data set over a long period of time, we will provide the most precise and best-identified quasi-experimental estimates of the effect of fasting on birth outcomes.

 描述（由申请人提供）： 低出生体重，这部分是由子宫内营养不良决定的，已被证明与儿童时期和以后生活中不利的健康和社会经济后果有关。先前的研究使用了合理的外源性事件，如饥荒，以确定子宫内营养和出生体重之间的因果关系。然而，这些关于营养对出生体重影响的估计存在生存偏差。这项拟议中的研究利用了一项自然实验，该实验由伊斯兰斋月期间母亲禁食的轻度营养冲击提供。斋月时间的特异性变化使我们能够合理地估计意向治疗效应对子宫内可能暴露于母亲禁食的儿童的因果影响。 鉴于低出生体重对儿童发育和成人健康的显著短期和长期影响，拟议研究的结果对政策制定者权衡与怀孕期间禁食和节食有关的政策干预措施的成本和收益具有相当大的价值。这项研究将使用德国1980年至2013年的人口出生和死亡记录。德国是一个穆斯林人口约400万的国家。 在这一抽样期间，我们将获得大约170万名穆斯林母亲分娩的数据。长期的观察期使我们能够从数据中排除所有季节性因素，因为斋月发生在33年期间的公历所有12个月。此外，与以前的研究不同，德国的数据使我们能够明确识别穆斯林和非穆斯林妇女，并提供有关出生体重，出生日期和各种协变量的确切信息。数据的一个独特特征使我们能够识别同一母亲的多胞胎，并控制未观察到的家庭间异质性，并利用兄弟姐妹之间潜在禁食行为的变化。我们还将能够检查子宫内暴露于潜在禁食的代际影响，因为出生记录也包含有关母亲出生日期的确切信息。最后，通过将出生记录与死亡记录联系起来，我们将被用来评估禁食对新生儿死亡率的影响。通过在很长一段时间内使用如此大的数据集，我们将提供禁食对出生结果影响的最精确和最佳识别的准实验估计。