Association of Prenatal Exposure to Economic Support Programs With Risk of Adverse Birth Outcomes
Statement of Problem
Approximately 50% of all pregnant people in the United States experience financial stress during pregnancy. Infants born to parents experiencing poverty and related material hardships are at increased risk of adverse birth outcomes. These adverse birth outcomes, including preterm birth and low birthweight, can lead to increased morbidity and mortality in infancy and alter long-term trajectories of child health and well-being.
Low-income pregnant people in the United States can receive economic support through multiple government benefit programs, including non-directed benefits, like tax credits, and directed benefits, like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Individuals exposed to multiple economic support programs during pregnancy may experience greater improvements in their health and well-being, culminating in healthier birth outcomes.
While evidence exists on the impacts of single economic support programs targeting pregnancy on birth outcomes, little research focuses on the potential synergistic impacts of prenatal exposure to multiple programs. Evaluating multiple programs’ effects together may more closely reflect the experience of low-income birthing people who often experience several socioeconomic risk factors simultaneously.
Description
This research will evaluate the health impacts of programs that provide economic supports for pregnant people and families. It will build on our team’s prior study showing that exposure to 2021 expanded child tax credit (eCTC) payments during pregnancy was associated with small, but statistically significant reductions in rates of adverse birth outcomes. It may also add to the evidence on how to optimize benefit program design and structure.
Through this project, our team will assess individual and combined impacts of two interventions targeting material and financial insecurity among pregnant people: the expanded child tax credit and WIC.
Using national Pregnancy Risk Assessment Monitoring System (PRAMS) data, we aim to:
- Investigate the association between expanded child tax credit (eCTC) receipt and birth outcomes
- Evaluate the association between WIC benefit receipt and birth outcomes
- Assess for synergistic effects on birth outcomes by comparing exposure to eCTC payments alone, WIC alone, or both benefits
By assessing associations between multiple programs and birth outcomes, this evaluation will offer important insights into how the effectiveness of these government benefit programs may vary based on eligibility, administrative requirements, and program design.
Next Steps
This work will inform future studies evaluating the specific mechanisms by which cash transfers and government benefits could improve maternal and child health outcomes and exploring additional strategies for optimizing benefit program design.
This page was last updated in March 2026.
Suggested Citation
Children's Hospital of Philadelphia, PolicyLab. Association of Prenatal Exposure to Economic Support Programs With Risk of Adverse Birth Outcomes [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here].