The impact of in utero malnutrition on “lost” births and neonatal mortality: Evidence from the 2002 food shortage in Malawi

Abstract: This study aims to look at the link between in utero malnutrition and the survival probabilities of fetuses and newborns, using the 2002 food shortages in Malawi as an instrument for malnutrition. Concretely, it looks at differences in the probability of a born child being a male and in neonatal mortality between children in utero affected by food scarcity and those born right before and after the food shortages. The obtained results show that there exist a link between intrauterine nutrition and early mortality. Moreover, they suggest that malnutrition may lead to a process of positive selection as early as in utero. Firstly, children are less likely to be males when belonging to food shortage-affected cohorts. Secondly, children affected by food scarcity are less prone to die within their first month of life. Both phenomena suggest that the cohort of children born after having been affected by intrauterine malnutrition represent a positive selection of what the cohort would have been in absence of the nutrition shock. These results have several implications, the most relevant one being that nutritional interventions targeting pregnant women may be a very cost-effective way of enhancing the life paths of many individuals, especially in those countries that are still threatened by food insecurity today.