Birth and Early Childhood Outcomes in Families Receiving an Unconditional Prenatal Cash Benefit
Notice bibliographique
Résumé
Importance: The Canadian province of Manitoba has offered an unconditional cash benefit (maximum CAD $81.41/mo) to low-income pregnant women since 2001. Evaluations have found the benefit was associated with improved birth and child development outcomes, but its effectiveness may be diminishing because the benefit amount has not changed in 20 years. Objective: To examine whether the Healthy Baby Prenatal Benefit remains an effective strategy for supporting maternal and child health. Design, Setting, and Participants: This retrospective cohort study was conducted among mothers with a singleton birth in Manitoba, Canada, from 2003 to 2019. Low-income mother-child dyads were identified using income assistance records. Data analyses were conducted from June to December 2024. Exposure: Receipt of the benefit during the second and third trimesters of pregnancy. Main Outcomes and Measures: Propensity scores and inverse probability of treatment weights were developed from sociodemographic information, which were used to reduce standardized differences between benefit recipients and nonrecipients. Risk ratios (RRs) for birth outcomes and developmental vulnerability in 5 domains at kindergarten were calculated. Results: The 17 970 benefit recipients (mean [SD] age at first birth, 19.52 [3.53] years) and 8301 nonrecipients (mean [SD] age at first birth, 19.38 [3.43] years). After applying inverse probability of treatment weights, all standardized differences were less than 0.10. From 2003 to 2019, the RRs increased among recipients vs nonrecipients for low birth weight (2003: RR, 0.68 [95% CI, 0.56-0.82]; 2019: RR, 0.92 [95% CI, 0.76-1.11]), preterm birth (2003: RR, 0.72 [95% CI, 0.62-0.83]; 2019: RR, 0.95 [95% CI, 0.83-1.09]), and small-for-gestational age (2003: RR, 0.83 [95% CI, 0.71-0.96]; 2019: RR, 0.97 [95% CI, 0.83-1.43]) and decreased for large-for-gestational age (2003: RR, 1.13 [95% CI, 1.01-1.26]; 2019: RR, 1.11 [95% CI, 0.99-1.24]) and breastfeeding initiation (2003: RR, 1.06 [95% CI, 1.02-1.10]; 2019: RR, 1.01 [95% CI, 0.98-1.05]). The RR for developmental vulnerability in kindergarten increased in the domains of language and cognitive development (2003: RR, 0.77 [95% CI, 0.66-0.89]; 2019: RR, 1.07 [95% CI, 0.94-1.21]) and communication and general knowledge (2003: RR, 0.83 [95% CI, 0.72-0.96]; 2019: RR, 0.93 [95% CI, 0.82-1.05]). Conclusions and Relevance: In this cohort study of low-income mothers and newborns, the associations of the Healthy Baby Prenatal Benefit with birth and child development outcomes diminished from 2003 to 2019, with many disappearing. Given the importance of prenatal health to these outcomes, these findings suggest that the benefit amount should be increased and adjusted for inflation in future years.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».