The effect of birthweight on childhood cognitive development in a middle-income country

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Date
2011
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Abstract
Methods We merge birth registry information on birthweight with standardized Math and Spanish test scores for all fourth graders in Chile to create a prospective data set. Twin fixed-effects models are used to estimate the causal effect of intra-uterine growth on test scores. Fixed-effect estimates are compared with traditional regression results in a cross-section of births to gauge the omitted variable bias emerging from unobserved genetic, maternal and pregnancy-related factors in cross-sectional models.
Results Birthweight differences within twin pairs have a substantial effect on test scores. A 400-g increase in birthweight results in a 15% standard deviation increase in Math scores. The effect is larger among (estimated) monozygotic than dizygotic pairs, reaching > 20% standard deviation. The effect varies across family socioeconomic status. It is strong among disadvantaged families but it nearly disappears among advantaged ones.
Conclusion Scarcity of uterine resources resulting in intra-uterine growth restriction has a detrimental effect on cognitive development in childhood. This effect interacts with family socioeconomic status (SES), so that low-SES families reinforce the effect of low birthweight and high-SES families fully compensate for it. Findings are particularly relevant in the developing world, where intra-uterine growth restriction is the main determinant of low birthweight.
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Keywords
Birthweight, twin studies, zygosity, fixed-effects, cognitive development, developing countries
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