Maternal Risk Exposure and Adult Daughters' Health, Schooling, and Employment: A Constructed Cohort Analysis of 50 Developing Countries

Abstract

This study analyzes the relationships between maternal risk factors present at the time of daughters' births-namely, young mother, high parity, and short preceding birth interval-and their subsequent adult developmental, reproductive, and socioeconomic outcomes. Pseudo-cohorts are constructed using female respondent data from 189 cross-sectional rounds of Demographic and Health Surveys conducted in 50 developing countries between 1986 and 2013. Generalized linear models are estimated to test the relationships and calculate cohort-level outcome proportions with the systematic elimination of the three maternal risk factors. The simulation exercise for the full sample of 2,546 pseudo-cohorts shows that the combined elimination of risk exposures is associated with lower mean proportions of adult daughters experiencing child mortality, having a small infant at birth, and having a low body mass index. Among sub-Saharan African cohorts, the estimated changes are larger, particularly for years of schooling. The pseudo-cohort approach can enable longitudinal testing of life course hypotheses using large-scale, standardized, repeated cross-sectional data and with considerable resource efficiency.

Keywords: Cohort analysis; Developing countries; Fertility; Life course; Reproductive health.

Fig. 1

Illustration of birth cohort construction and linkage across DHS rounds

Fig. 2

Analytic framework, with birth cohorts as units of analysis. ^aMaternal age >34 years not specified due to multicollinearity with other risk factors

Fig. 3

Means and average proportions of constructed cohorts (n = 2,546) for health and socioeconomic outcomes and maternal risk factors, by year of survey

Fig. 4

Observed minus expected change in estimated cohort proportions or averages after eliminating all maternity risk factors by cohort birth year or age at time of outcome survey. Diamond symbols are for all regions; x symbols are for SSA region only. Vertical axes are as follows: A = Change in proportion of children who died before age 5; B = Change in proportion of mothers who report ever losing a child by age 5; C = Change in proportion of children reported born small; D = Change in proportion of mothers ever having a small baby; E = Change in proportion of adult daughters with BMI <18.5; F = Change in proportion of adult daughters with height <145cm; G = Change in proportion of adult daughters with paid work; H = Change in adult daughter’s average years of education