City Research Online

Abstract

Low birth weight and preterm birth are key indicators of neonatal health, influencing both immediate and long-term infant outcomes. While low birth weight may reflect fetal growth restrictions, preterm birth captures disruptions in gestational development. Ignoring the potential interdependence between these variables may lead to an incomplete understanding of their shared determinants and underlying dynamics. To address this, a copula distributional regression framework is adopted to jointly model both indicators as flexible functions of maternal characteristics and geographic effects. Applied to female birth data from North Carolina, the methodology identifies shared factors of low birth weight and preterm birth, and reveals how maternal health, socioeconomic conditions and geographic disparities shape neonatal risk. The joint modeling approach provides a more nuanced understanding of these birth metrics, offering insights that can inform targeted interventions, prenatal care strategies and public health planning.

Publication Type:	Article
Additional Information:	This is the peer reviewed version of the following article: Marra, G. & Radice, R. (2025). Joint Modeling of Birth Outcomes Using a Copula Distributional Regression Approach. Health Economics, which has been published in final form at https://onlinelibrary.wiley.com/journal/10991050. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Publisher Keywords:	birth outcomes, copula regression, joint modeling, low birth weight, preterm birth, spatial effects, maternal risk factors
Subjects:	H Social Sciences > HN Social history and conditions. Social problems. Social reform R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RG Gynecology and obstetrics
Departments:	Bayes Business School Bayes Business School > Faculty of Actuarial Science & Insurance
SWORD Depositor:	Symplectic Administrator

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