334 - Paternal non-involvement is a social determinant of first-year mortality due to respiratory conditions: a population-based study

Poster Number: 334
Publication Number: 334.1989

Background: Respiratory conditions are a leading cause of first-year mortality among births to US-born non-Hispanic White, Hispanic, and African American (AA) women (Collins et al, MCHJ, 2013). Paternal acknowledgment on their infant’s birth certificate is a proxy of paternal involvement. The relationship between paternal involvement and infant mortality rates due to respiratory conditions ( < 365d, IMR-RC) is unknown.

Objective: To determine the extent to which paternal acknowledgement is associated with the IMR-RC in the three-leading race/ethnic groups of US-born women.

Design/Methods: Stratified and multivariable binomial regression analyses were performed on the 2016-2019 National Center for Health Statistics linked live birth-death cohort dataset of births to US-born non-Hispanic White (N=7,060,272), Hispanic (N=1,487,036), and AA (N=1,775,931) women.

Results: The prevalence of paternal non-acknowledgment ranged from 7% for non-Hispanic White and 13% for Hispanic to 32% for AA women. In each Race/ethnic-group, IMR-RC were higher among births to non-acknowledged (versus married-acknowledged) fathers (Fig 1). This disparity was widest among non-Hispanic White women where births to non-acknowledged fathers had an IMR-RC of 2.3/10,000 versus only 0.6/10,000 for births to acknowledged-married fathers, RR = 3.8 (3.1, 4.17). In each racial/ethnic group, births to non-acknowledged (versus acknowledged) fathers had a greater percentage of high-risk maternal characteristics (Table 1). The adjusted (controlling for selected co-variates) RR of first-year mortality due to RC among births to non-Hispanic White, Hispanic, and AA women with non-acknowledged (versus acknowledged-married) fathers equaled 1.7 (1.3, 2.2), 1.5 (1.1, 2.0) and 1.5 (0.9, 2.6), respectively (Table 2). The PAR% of infant deaths due to respiratory conditions for paternal non-acknowledgement (compared to acknowledged-married) among non-Hispanic White and AA women equaled 5% and 14%, respectively. There were too few deaths to calculate meaningful PAR% for Hispanic women.

Conclusion(s): Paternal non-acknowledgment is associated with IMR-RC among births to the three-leading racial/ethnic groups of US-born women. However, reflecting the strikingly high prevalence of paternal non-acknowledgment among births to AA women, this intriguing phenomenon has particular public health relevance to the AA infant’s survival disadvantage.