Impacts of Prenatal Care on Infant and Early Childhood Health: A Panel Data Approach

The correlation between poor health at birth and future adverse health and economic status is well established, and a large body of extant literature has focused on prenatal care as a potential channel for improving infant health at birth by increasing birth weight. The results of these studies have generally been mixed, with some finding positive impacts of prenatal care and others finding insignificant impacts, and the vast majority of them have employed an instrumental variables strategy to control for the potential endogeneity of the decision to seek prenatal care. Our study investigates the impacts of prenatal care on infant birth weight and early life health care utilization using Natality data and Medicaid claims from South Carolina for births between 2004 and 2012. As we observe 135,000 mothers with multiple births in our sample, we control for the potential endogeneity of prenatal care and estimate these impacts by employing a maternal fixed effects strategy, which accounts for any unobserved time-invariant maternal characteristics, and including a rich set of controls for prior pregnancy outcomes. We also extend on much of the prior literature by estimating the impacts of prenatal care not only on birth weight, but also on early childhood health care utilization. Finally, we estimate whether there are heterogeneous impacts of prenatal care across the birth order distribution to explore the hypothesis that one mechanism through which prenatal care impacts future outcomes is by providing a mother information and education.