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The introduction of a child day-care system is one of the early welfare interventions targeted towards mothers and young children that over time gained great prominence in the Swedish welfare state. Because quantitative research on day-cares in historical settings is generally scarce, in this study, we focus on the determinants of day-care enrolment in southern Sweden during the early twentieth century. We use unique individual-level records of day-care attendance for children born between 1900 and 1935 which have been linked to longitudinal micro-level data for the city of Landskrona obtained from the Scanian Economic Demographic Database. Event-history techniques are employed to analyse the importance of factors such as household composition, parental socio-economic background, marital status of the mother, and mother’s occupation. Of the studied children, 8% were ever enrolled in day-cares, most of them around the ages 3 to 6. The results show that the mother’s marital status, household SES, number of siblings, the presence of other adult females in the household and mother’s occupation are all significant determinants of day-care attendance for children. In this study, we show that in the early twentieth century in southern Sweden, day-care attendance followed a negative SES gradient and was most common among children of single mothers.

Increased population longevity could be influenced by early life factors. Some areas have long-lived populations, also in a historical perspective. We aimed to study these factors in Halland, an area with the highest life expectancy in Sweden. We collected archival data on gestational age and birth characteristics from 995 live singleton full-term births at the Halmstad Hospital, Halland, from the period 1936 to 1938 and compared these to 3364 births from three hospitals in nearby Scania for the period 1935–1945. In addition, data were obtained on maternal and offspring characteristics from the national Swedish Medical Birth Register during 1973–2013. The results show that when controlling for background maternal and offspring characteristics, mean birth weight (BW) and mean birth length were higher in Halland than in Scania, but the proportion of low birth weight (LBW) and small for gestational age (SGA) was lower. However, mean BW for Halland did not differ from the rest of Sweden in recent years 2004–2013. We also conducted a mortality follow-up for children born in Scania, which showed that LBW, being born SGA, or short birth length reduced survival. In conclusion, the high mean life expectancy in Halland compared to the rest of Sweden could have been associated with beneficial early life factors influencing birth size in the past. In more recent decades the mean BW of Halland is not different from the national mean. Thus, longevity could be expected to become more equal to the national mean in the future.

Using data from southern Sweden, this work analyses the development of maternal and infant health in five rural parishes and the town of Landskrona in Scania, Sweden, in the last 110 years. First, we address the overall development of maternal, perinatal and infant health using a range of indicators, such as maternal mortality, neonatal mortality, and stillbirth rates. We also describe how institutional and medical changes reached the town of Landskrona and the surrounding rural areas. Second, we relate the development of maternal and infant health to the institutions and medical innovations available in the area, such as the expansion of hospital facilities, availability of antibiotics and the opening of maternity wards and neonatal intensive care units. We estimate the magnitude of the impact on a range of indicators of mother and infant health using time series analysis.

Early-life adversity negatively affects morbidity and survival in late life, but knowledge is limited about effects on women’s reproduction and reproductive health. To deepen our understanding of the full effects of disease exposure in early life, including long-term consequences, we study women’s reproductive outcomes and their offspring’s health. Using the Scanian Economic Demographic Database and Swedish register data covering close to a century (1905-2000), in combination with local infant mortality rates as a measure of disease exposure in the year of birth, we follow women’s reproductive careers over their life course, examining a comprehensive set of outcomes. Results show that women exposed to disease in infancy give birth to a lower proportion of boys (lower offspring sex ratio), which is in line with the notions that male fetuses are more vulnerable to their mother’s adverse physical or contextual conditions and that pregnancies with male fetuses are more often miscarried. We also find that boys of exposed mothers are more likely to be born preterm and are heavier than boys born to non-exposed mothers, suggesting in utero out-selection of weaker male fetuses. Moreover, exposed women have a higher risk of miscarriage and of male stillbirth, but we do not find strong evidence that their overall likelihood of giving birth is affected. Taken together, our results imply that disease exposure in infancy has a continuous impact on reproduction and health across the female life course, and even affects the early-life health of the next generation.