Child Health and the Impact of Maternal Fasting

 描述(申请人提供)：出生体重低，这部分是由子宫营养不良决定的，已被证明与儿童时期和以后的生活中的不利健康和社会经济后果有关。先前的研究已经使用看似合理的外源性事件，如饥荒，来确定宫内营养和出生体重之间的因果联系。然而，这些对营养对出生体重影响的估计受到生存偏差的影响。这项拟议的研究利用了一项自然实验，该实验是由伊斯兰斋月期间母亲禁食带来的轻微营养休克提供的。斋月时间的特殊变化使我们能够可信地估计意图治疗效应对那些在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重大短期和长期影响，拟议的研究结果对于权衡与怀孕期间禁食和节食相关的政策干预的成本和收益具有相当大的价值。这项研究将使用德国从1980年到2013年的人口出生和死亡记录。德国是一个穆斯林人口约为400万的国家。在这一样本期间，我们将拥有大约170万名穆斯林母亲分娩的数据。长的观察期使我们能够从数据中扣除所有的季节性，因为斋月发生在公历的所有12个月期间，在33年的时间里。此外，与之前的研究不同，德国的数据使我们能够明确地识别穆斯林和非穆斯林女性，并提供关于出生体重、出生日期和一系列协变量的准确信息。数据的一个独特功能使我们能够识别同一位母亲的多胞胎，控制未被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差异。我们还将能够检查宫内暴露于潜在禁食的代际影响，因为出生记录也包含关于母亲出生日期的准确信息。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庞大的数据集，我们将提供禁食对出生结果影响的最准确和最好识别的准实验估计。

 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.