Abstract
Objectives
Maternal race, marital status, and social environment impact risk of preterm delivery and size for gestational age. Although some paternal characteristics such as age are associated with pregnancy outcomes, the influence of the paternal presence, race/ethnicity and adverse life events is not well known. The objective of the study was to assess birth outcomes in mothers with a paternal presence compared to those without during the post-partum period. The secondary aim was to determine whether paternal race is associated with birth outcomes.
Methods
This was a cross-sectional study using parental surveys linked with birth certificate data from 2016 to 2018. Adverse birth composite outcomes (ABCO) including small for gestational age (SGA), prematurity or neonatal intensive care unit admission (NICU) were assessed.
Results
A total of 695 parents were analyzed (239 single mothers and 228 mother-father pairs). Compared to mothers with a father present, mothers without a father present exhibited increased odds of ABCO, prematurity and NICU. Non-Hispanic Black fathers had increased odds of ABCO and NICU compared to Non-Hispanic Whites (NHW). Hispanic fathers had increased odds of NICU compared to NHW.
Conclusions
Paternal absence in the post-partum period and paternal race were both independently associated with ABCO and NICU. Assessment of paternal presence and paternal race in clinical practice may help identify opportunities for additional support necessary to optimize birth outcomes.
Acknowledgments
We would like to thank all the mothers and fathers who took the time to participate in this study. We also would like to thank the following medical student research assistants: Christopher Stoll, Daniel Schwab, Brian Hanyok, Brian Yost, Mayra Ramirez, Jennifer Kutt, Dana Greene, Sarah Spiegel, Amythis Soltani, Mohammed Alzoobaee, Janki Shah, Bianca Zapanta, Maliha Rahman, Bryony Lucas.
-
Research funding: None declared
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: Authors state no conflict of interest and no financial interests.
-
Informed consent: Informed consent was obtained from all individuals included in this study.
-
Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors' Institutional Review Board.
References
1. Martin, JA, Hamilton, BE, Osterman, MJK, Driscoll, AK, Mathews, TJ. Births: final data for 2015. Natl Vital Stat Rep 2017;66:1.Search in Google Scholar
2. Jensen, EA, Foglia, EE, Dysart, KC, Simmons, RA, Aghai, ZH, Cook, A, et al.. Adverse effects of small for gestational age differ by gestational week among very preterm infants. Arch Dis Child Fetal Neonatal Ed 2019;104:F192–8, https://doi.org/10.1136/archdischild-2017-314171.Search in Google Scholar PubMed PubMed Central
3. Harrison, W, Goodman, D. Epidemiologic trends in neonatal intensive care, 2007–2012. JAMA Pediatr 2015;169:855–62, https://doi.org/10.1001/jamapediatrics.2015.1305.Search in Google Scholar PubMed
4. McCowan, LM, Roberts, CT, Dekker, GA, Taylor, RS, Chan, EH, Kenny, LC, et al.. Risk factors for small-for-gestational-age infants by customized birthweight centiles: data from an international prospective cohort study. BJOG 2010;117:1599–607, https://doi.org/10.1111/j.1471-0528.2010.02737.x.Search in Google Scholar PubMed
5. Vogel, JP, Chawanpaiboon, S, Moller, AB, Watananirun, K, Bonet, M, Lumbiganon, P. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol 2018;52:3–12, https://doi.org/10.1016/j.bpobgyn.2018.04.003.Search in Google Scholar PubMed
6. Collins, JWJr, Wu, SY, David, RJ. Differing intergenerational birth weights among the descendants of US-born and foreign-born Whites and African Americans in Illinois. Am J Epidemiol 2002;155:210–6, https://doi.org/10.1093/aje/155.3.210.Search in Google Scholar PubMed
7. Ruiz, M, Goldblatt, P, Morrison, J, Kukla, L, Švancara, J, Riitta-Järvelin, M, et al.. Mother’s education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts. J Epidemiol Community Health 2015;69: 826e33, https://doi.org/10.1136/jech-2014-205387.Search in Google Scholar PubMed PubMed Central
8. Vogel, JP, Lee, AC, Souza, JP. Maternal morbidity and preterm birth in 22 low- and middle-income countries: a secondary analysis of the WHO global survey dataset. BMC Pregnancy Childbirth 2014;14:56, https://doi.org/10.1186/1471-2393-14-56.Search in Google Scholar PubMed PubMed Central
9. Chae, DH, Clouston, S, Martz, CD, Hatzenbuehler, ML, Cooper, HLF, Turpin, R, et al.. Area racism and birth outcomes among Blacks in the United States. Soc Sci Med 2018;199:49–55, https://doi.org/10.1016/j.socscimed.2017.04.019.Search in Google Scholar PubMed PubMed Central
10. Staneva, A, Bogossian, F, Pritchard, M, Wittkowski, A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. Women Birth 2015;28:179e93, https://doi.org/10.1016/j.wombi.2015.02.003.Search in Google Scholar PubMed
11. Nkansah-Amankra, S, Luchok, KJ, Hussey, JR, Watkins, K, Liu, X. Effects of maternal stress on low birth weight and preterm birth outcomes across neighborhoods of South Carolina, 2000–2003. Matern Child Health J 2010;14:215–26, https://doi.org/10.1007/s10995-009-0447-4.Search in Google Scholar PubMed
12. Negrato, CA, Mattar, R, Gomes, MB. Adverse pregnancy outcomes in women with diabetes. Diabetol Metab Syndrome 2012;4:41, https://doi.org/10.1186/1758-5996-4-41.Search in Google Scholar PubMed PubMed Central
13. Burris, HH, Collins, JW, Wright, RO. Racial/ethnic disparities in preterm birth: clues from environmental exposures. Curr Opin Pediatr 2011;23:227–32, https://doi.org/10.1097/mop.0b013e328344568f.Search in Google Scholar PubMed PubMed Central
14. Brumberg, HL, Shah, SI. Born early and born poor: an eco-bio-developmental model for poverty and preterm birth. J Neonatal Perinat Med 2015;8:179–87, https://doi.org/10.3233/npm-15814098.Search in Google Scholar
15. Brumberg, HL, Shah, SI. Got daddy issues? Fathers impact on perinatal outcomes. Semin Perinatol 2020;44:151238, https://doi.org/10.1016/j.semperi.2020.151238.Search in Google Scholar PubMed
16. Raatikainen, K, Heiskanen, N, Heinonen, S. Marriage still protects pregnancy. BJOG 2005;112:1411–6, https://doi.org/10.1111/j.1471-0528.2005.00667.x.Search in Google Scholar PubMed
17. Zeitlin, JA, Saurel-Cubizolles, MJ, Ancel, PY, EUROPOP Group. Marital status, cohabitation, and risk of preterm birth in Europe: where births outside marriage are common and uncommon. Paediatr Perinat Epidemiol 2002;16:124–30, https://doi.org/10.1046/j.1365-3016.2002.00396.x.Search in Google Scholar PubMed
18. Shah, PS. On behalf of the knowledge synthesis group on determinants of preterm/low birthweight births. Paternal factors and low birthweight, preterm, and small for gestational age births: a systematic review. Am J Obstet Gynecol 2010;202:103, https://doi.org/10.1016/j.ajog.2009.08.026.Search in Google Scholar PubMed
19. Meng, Y, Groth, SW. Fathers count: the impact of paternal risk factors on birth outcomes. Matern Child Health J 2018;22:401–8, https://doi.org/10.1007/s10995-017-2407-8.Search in Google Scholar PubMed PubMed Central
20. Hurley, EG, DeFranco, EA. Influence of paternal age on perinatal outcomes. Am J Obstet Gynecol 2017;217:566–6, https://doi.org/10.1016/j.ajog.2017.07.034.Search in Google Scholar PubMed
21. Collins, JWJr, Rankin, KM, David, RJ. Paternal lifelong socioeconomic position and low birth weight rates: relevance to the African–American women’s birth outcome disadvantage. Matern Child Health J 2016;20:1759–66, https://doi.org/10.1007/s10995-016-1981-5.Search in Google Scholar PubMed
22. Raatikainen, K, Heiskanen, N, Heinonen, S. Does unemployment in family affect pregnancy outcome in conditions of high quality maternity care? BMC Publ Health 2006;6:46, https://doi.org/10.1186/1471-2458-6-46.Search in Google Scholar PubMed PubMed Central
23. Mutsaerts, MAQ, Groen, H, Buiter-Van der Meer, A, Sijtsma, A, Sauer, PJJ, Land, JA, et al.. Effects of paternal and maternal lifestyle factors on pregnancy complications and perinatal outcome. A population-based birth-cohort study: the GECKO Drenthe cohort. Hum Reprod 2014;29:824–34, https://doi.org/10.1093/humrep/deu006.Search in Google Scholar PubMed
24. Northam, S, Knapp, TR. The reliability and validity of birth certificates. J Obstet Gynecol Neonatal Nurs 2006;35:3–12, https://doi.org/10.1111/j.1552-6909.2006.00016.x.Search in Google Scholar PubMed
25. Cheng, ER, Hawkins, SS, Rifas-Shiman, SL, Gillman, MW, Taveras, EM. Association of missing paternal demographics on infant birth certificates with perinatal risk factors for childhood obesity. BMC Publ Health 2016;16:453, https://doi.org/10.1186/s12889-016-3110-1.Search in Google Scholar PubMed PubMed Central
26. Gould, JB, Chavez, G, Marks, AR, Liu, H. Incomplete birth certificates: a risk marker for infant mortality. Am J Publ Health 2002;92:79–81, https://doi.org/10.2105/ajph.92.1.79.Search in Google Scholar PubMed PubMed Central
27. Buescher, PA, Gizlice, Z, Jones-Vessey, KA. Discrepancies between published data on racial classification and self-reported race: evidence from the 2002 North Carolina live birth records. Publ Health Rep 2005;120:393–8, https://doi.org/10.1177/003335490512000406.Search in Google Scholar PubMed PubMed Central
28. Kressin, NR, Chang, BH, Hendricks, A, Kazis, LE. Agreement between administrative data and patients’ self-reports of race/ethnicity. Am J Public Health 2003;93:1734–9, https://doi.org/10.2105/ajph.93.10.1734.Search in Google Scholar PubMed PubMed Central
29. Wanasinghe, D, Shah, S, Bamanikar, A, Aboudi, D, Mikkilineni, S, Shyong, O, et al.. Lifestyle characteristics of parental electronic cigarette and marijuana users: healthy or not? J Perinat Med 2019;48:59–66, https://doi.org/10.1515/jpm-2019-0392.Search in Google Scholar PubMed
30. Alio, AP, Mbah, AK, Kornosky, JL, Wathington, D, Marty, PJ, Salihu, HM. Assessing the impact of paternal involvement on racial/ethnic disparities in infant mortality rates. J Community Health 2011;36:63–8, https://doi.org/10.1007/s10900-010-9280-3.Search in Google Scholar PubMed
31. New York state birth certificate and statewide perinatal data system work booklet. DOH-2184E (5/11). New York State Department of Health. Available from: https://commerce.health.state.ny.us/hpn/ctrldocs/spds/Workbooklet_11.pdf.Search in Google Scholar
32. Fenton, TR, Kim, JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr 2013;13:59, https://doi.org/10.1186/1471-2431-13-59.Search in Google Scholar PubMed PubMed Central
33. Soteriades, ES, DiFranza, JR. Parent’s socioeconomic status, adolescents’ disposable income, and adolescents’ smoking status in Massachusetts. Am J Public Health 2003;93:1155–60, https://doi.org/10.2105/ajph.93.7.1155.Search in Google Scholar PubMed PubMed Central
34. Galobardes, B, Shaw, M, Lawlor, DA, Lynch, JW, Smith, GD. Indicators of socioeconomic position (part 1). J Epidemiol Community Health 2006;60:7–12, https://doi.org/10.1136/jech.2004.023531.Search in Google Scholar PubMed PubMed Central
35. El-Sayed, AM, Galea, S. Changes in the relationship between marriage and preterm birth, 1989–2006. Publ Health Rep 2011;126:717–25, https://doi.org/10.1177/003335491112600514.Search in Google Scholar PubMed PubMed Central
36. McLanahan, S, Garfinkel, I, Brooks-Gunn, J, Zhao, H, Johnson, W, Rich, L, et al.. Unwed fathers and fragile families Report No.: Working Paper#98-12. Princeton NJ: Center for Research on Child Wellbeing; 1998. Available from: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.457.8942&rep=rep1&type=pdf.Search in Google Scholar
37. Ghosh, JK, Wilhelm, MH, Dunkel-Schetter, C, Lombardi, CA, Ritz, BR. Paternal support and preterm birth, and the moderation of effects of chronic stress: a study in Los Angeles County mothers. Arch Wom Ment Health 2010;13:327–38, https://doi.org/10.1007/s00737-009-0135-9.Search in Google Scholar PubMed PubMed Central
38. Ma, S. Paternal race/ethnicity and birth outcomes. Am J Publ Health 2008;98:2285–92, https://doi.org/10.2105/ajph.2007.117127.Search in Google Scholar
39. Shapiro, GD, Bushnik, T, Sheppard, AJ, Kramer, MS, Kaufman, JS, Yang, S. Missing paternal data and adverse birth outcomes in Canada. Health Rep 2016;27:3–9.Search in Google Scholar
40. Misra, DP, Caldwell, C, Young, AAJr, Abelson, S. Do fathers matter? Paternal contributions to birth outcomes and racial disparities. Am J Obstet Gynecol 2010;202:99–100, https://doi.org/10.1016/j.ajog.2009.11.031.Search in Google Scholar PubMed
41. Korenman, S, Kaestner, R, Joyce, T. Consequences for infants of parental disagreement in pregnancy intention. Perspect Sex Reprod Health 2002;34:198–205, https://doi.org/10.2307/3097730.Search in Google Scholar
42. Meng, Y, Groth, SW. Fathers count: the impact of paternal risk factors on birth outcomes. Matern Child Health J 2018;22:401–8, https://doi.org/10.1007/s10995-017-2407-8.Search in Google Scholar PubMed PubMed Central
43. Fulda, KG, Kurian, AK, Balyakina, E, Moerbe, MM. Paternal race/ethnicity and very low birth weight. BMC Pregnancy Childbirth 2014;14:385, https://doi.org/10.1186/s12884-014-0385-z.Search in Google Scholar PubMed PubMed Central
44. Niknazar, S, Nahavandi, A, Peyvandi, AA, Peyvandi, H, Roozbahany, NA, Abbaszadeh, HA. Hippocampal NR3C1 DNA methylation can mediate part of preconception paternal stress effects in rat offspring. Behav Brain Res 2017;324:71–6, https://doi.org/10.1016/j.bbr.2017.02.014.Search in Google Scholar PubMed
45. Harker, A, Raza, S, Williamson, K, Kolb, B, Gibb, R. Preconception paternal stress in rats alters dendritic morphology and connectivity in the brain of developing male and female offspring. Neuroscience 2015;303:200–10, https://doi.org/10.1016/j.neuroscience.2015.06.058.Search in Google Scholar PubMed
46. Pieterse, AL, Carter, RT. An examination of the relationship between general life stress, racism-related stress, and psychological health among black men. J Counsel Psychol 2007;54:101–9, https://doi.org/10.1037/0022-0167.54.1.101.Search in Google Scholar
47. Lu, MC, Kotelchuck, M, Hogan, V, Jones, L, Wright, K, Halfon, N. Closing the black–white gap in birth outcomes: a life-course approach. Ethn Dis 2010;20(1 Suppl 2):S2–76.Search in Google Scholar
48. Morton, SM, Bandara, DK, Robinson, EM, Carr, PE. In the 21st century, what is an acceptable response rate? Aust N Z J Publ Health 2012;36:106–8, https://doi.org/10.1111/j.1753-6405.2012.00854.x.Search in Google Scholar PubMed
49. Fulda, KG, Kurian, AK, Balyakina, E, Moerbe, MM. Paternal race/ethnicity and very low birth weight. BMC Pregnancy Childbirth 2014;14:385, https://doi.org/10.1186/s12884-014-0385-z.Search in Google Scholar PubMed PubMed Central
50. Hodek, JM, von der Schulenburg, JM, Mittendorf, T. Measuring economic consequences of preterm birth – methodological recommendations for the evaluation of personal burden on children and their caregivers. Health Econ Rev 2011;1:6, https://doi.org/10.1186/2191-1991-1-6.Search in Google Scholar PubMed PubMed Central
51. Lu, MC, Jones, L, Bond, MJ, Wright, K, Pumpuang, M, Maidenberg, M, et al.. Where is the F in MCH? Father involvement in African American families. Ethn Dis 2010;20(1 Suppl 2):S2-49–61.Search in Google Scholar
© 2021 Walter de Gruyter GmbH, Berlin/Boston