Adverse Birth Outcomes

Improved Targeting to Prevent Adverse Birth Outcomes Using Big Data in the Netherlands

Abstract

A strong link has been documented between adverse birth outcomes and compromised health from early childhood to adulthood. Hence, policymakers may consider targeting their policies toward specific geographic areas and demographic groups with a high incidence of adverse birth outcomes. In this paper, we document the association between adverse birth outcomes and a wide range of sociodemographic circumstances by linking the universe of all 1,500,690 births in the Netherlands between 2008 and 2016 to administrative data on home addresses, household incomes, and migration backgrounds of parents.

We present three sets of results. First, birth outcomes in the Netherlands vary substantially by parental income: 19.1 percent of low-income births are small-for-gestational-age (SGA) versus 8.5 percent of high-income births; 8.2 percent of low-income births are preterm versus 5.5 percent of high-income births; and the infant mortality rate is 1.1 percent among low-income births versus 0.4 percent among high-income births.

Second, we observe substantial geographic variation in birth outcomes among low-income parents, defined as parents with an income at the 25th percentile of the parental income distribution, or € 54,365. When compared to low-income parents in the geographic center of the Netherlands, parents with a similar income in the former mining zone in the southeast of the Netherlands were twice as likely to experience SGA births (18.4 percent versus 8.9 percent, respectively), 1.8 times more likely to experience premature births (10.3 percent versus 5.8 percent), and 2.8 times more likely to face infant mortality (1.04 percent versus 0.37 percent).

Third, areas where low-income parents are more likely to experience adverse birth outcomes are characterized by relatively large shares of Roman Catholic and Muslim, but not Protestant Christian, residents; large shares of residents with an immigrant background; and large vote shares for two populist parties on the left and the right of the political spectrum.

Controlling for parental income, strong geographic variation in birth outcomes persists in the Netherlands. We have developed two publicly available interactive websites to help policymakers and health professionals in targeting these policies and interventions in the Netherlands. Furthermore, we have compiled a publicly available dataset that can be used by other researchers to examine the determinants of adverse birth outcomes.

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