Marriage Advantages in Perinatal Health: Evidence of Marriage Selection or Marriage Protection?

Marriage is a social tie associated with health advantages for adults and their children, as lower rates of preterm birth and low birth weight are observed among married women. This study tests two competing hypotheses explaining these marriage advantages-marriage protection versus marriage selection-using a sample of recent births to single, cohabiting, and married women from the National Survey of Family Growth, 2006-10. Propensity score matching and fixed effects regression results demonstrate support for marriage selection, as a rich set of early life selection factors account for all of the cohabiting-married disparity and part of the single-married disparity. Subsequent analyses demonstrate prenatal smoking mediates the adjusted single-married disparity in birth weight, lending some support for the marriage protection perspective. Study findings sharpen our understanding of why and how marriage matters for child well-being, and provide insight into preconception and prenatal factors describing intergenerational transmissions of inequality via birth weight.