Três ensaios sobre a origem da vida e seus efeitos sobre o Capital Humano

Abstract

This thesis is composed of three independent essays, but linked by the same theme, to understand the relationship between events that occur during pregnancy until birth in fetal and child development. The first article investigates how maternal stress during pregnancy impacts fetal and child development and whether the effects manifest differently in boys and girls throughout the life cycle. The earthquake that occurred in Chile in 2010 is used as an exogenous source of stress and the Early Childhood Research is used to monitor the development of children. The results found corroborate previous evidence that maternal stress during management, especially in the first two trimesters, is a risk factor for the full development of the fetus. It is important to emphasize that the effects found in birth measurements are stronger for boys compared to girls. The analysis along the life cycle indicates a greater sensitivity of girls, especially with regard to socio-emotional skills. The second article explores a less investigated aspect in the literature, a possible impact on the sex ratio of live births affected by a negative shock, specifically the Brumadinho dam failure in 2019. Using a synthetic differences-in-differences strategy, we find a reduction in the sex ratio of live births in those municipalities affected by the disaster. The negative effect is stronger in the municipalities closest to the rupture site and is manifested if the pregnant woman was in the beginning or middle of pregnancy at the time of the rupture. The third article evaluates a program aimed at reducing cesarean sections without clinical indications, the Projeto Parto Adequado. The main objective is to assess whether the project was able to reduce cesarean section rates in participating hospitals. A synthetic difference-in-differences estimation is used in this article, comparing the evolution of the indicators of interest for the hospitals participating in the project with a group of similar hospitals over a period of time before and after the implementation of the project. The results found point to an effect of the project on the increase in normal birth rates of more than three percentage points, which represents a more than 25% increase compared to the rates of 2014, the year immediately prior to the implementation of the Project. In order to verify the focus of the project, an estimation was performed only for low-risk pregnancies. For this group, the effect was higher, around five percentage points, representing a growth of more than 31% compared to 2014 levels