363 - The effect of father’s involvement on African-American & non-Latina White women’s risk of preterm birth: a population-based study of subsequent births to women whose prior births had involved fathers

Publication Number: 363.6934

Shayna Hibbs, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Rachel A. Wilkinson, Icahn School of Medicine at Mount Sinai, New York, NY, United States; John M. Perry, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Kristin Rankin, University of Illinois at Chicago School of Public Health, Chicago, IL, United States; James Collins, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States

Background: A burgeoning area of research has emerged focusing on the contribution of father’s involvement to preterm birth ( < 37 weeks, PTB). Paternal non-acknowledgement on the infant’s birth certificate, a proxy of paternal non-involvement, is a risk factor for PTB. The PTB rate of subsequent births to women whose prior births had involved fathers is unknown.

Objective: To determine the relationship between paternal involvement and PTB among subsequent births to African-American (AA) and non-Latina White (NL-W) women whose prior births had involved fathers.

Design/Methods: Stratified and multivariable modified Poisson regression analyses were performed on the Illinois transgenerational birth-file of infants born 1989-1991. Only subsequent births to women whose prior births had acknowledged fathers on their birth certificate were studied.

Results: The prevalence of subsequent births with non-acknowledged (non-ack) fathers was dramatically greater among AA (compared to NL-W) women whose prior birth had acknowledged fathers, p < 0.001 (Figure 1). NL-W women with subsequent births (n=438) to non-ack fathers had a PTB rate of 14.2% compared to only 6.9% for those (n=16,453) with subsequent births to acknowledged fathers, RR = 2.1 (95% CI = 1.6, 2.6). AA women with subsequent births (n=1,030) to non-ack fathers had a PTB rate of 23.4% vs. 17.4% for those (n=1,954) with ack fathers, RR = 1.3 (1.2, 1.6). Paternal non-acknowledgment (compared to acknowledgment) was associated with increased race-specific rates of early ( < 34 wks) and late (34-36 wks) PTB (Figure 2). In both races, subsequent births with non-ack fathers had a greater percentage of high-risk maternal characteristics and behaviors than those with acknowledged fathers (Table). The adjusted (controlling for maternal demographic, medical, and behavioral risk factors) RR of PTB for subsequent births to NL-W and AA women with non-ack (compared to acknowledged) fathers equaled 1.4 (1.1, 1.8) and 1.3 (1.1, 1.6), respectively. The Population Attributable Risk % of PTB for subsequent births with non-acknowledged fathers to NL-W and AA women whose prior births had acknowledged fathers equaled 1.5% and 9.5%, respectively.

Conclusion(s): In both races, paternal non-involvement is a risk factor for early and late PTB among subsequent births to women whose prior births had involved fathers. Reflecting the dramatically greater prevalence of paternal non-acknowledgment among births to AA (compared to NL-W) women, this finding has particular public health relevance to AA women’s PTB rate disadvantage.

Figure 1
Prevalence of Paternal Acknowledgment in Subsequent Births to Women Whose Prior Births had Acknowledged Fathers


Figure 2
Rates of Early ( <34 weeks) and Late (34-36 weeks) Preterm Birth by Race And Paternal Acknowledgment (Prior Birth to Acknowledged Father)

Distribution (percent) of Selected Maternal High-Risk Characteristics and Pregnancy-Related Behaviors by Race and Paternal Acknowledgment in Subsequent Births to Women Whose Prior Births had Acknowledged Fathers
*= met statistical significance