142nd APHA Annual Meeting and Exposition

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Contribution of father'a early-life and adulthood economic position to African-American mother's pregnancy outcome: A population-based study

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 2:30 PM - 2:45 PM

James Collins Jr., MD, MPH , Pediatrics, Northwestern University Feinberg School of Medicine, chicago, IL
Kristin M. Rankin, PhD , Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL
Richard J. David, MD , Stroger Cook County Hospital, University of Illinois at Chicago, Chicago, IL
Background.  Studies have rarely considered the contribution of paternal factors to the racial disparity in birth outcome.    

Objective.   To determine the extent to which paternal lifelong economic position is a risk factor for low birth weight (< 2500g, LBW) among African-American women.  

Methods. Stratified and multilevel logistic regression analyses were performed on an Illinois transgenerational dataset of African-American infants (1989-1991), their mothers (1956-1976), and fathers (1956-1976) with appended U.S. census income information.


Results.   In Cook County IL, infants born to fathers (n=356) with a lifelong residence in high-income neighborhoods had a LBW rate of only 5.6%.  In contrast, infants born to fathers with an early-life (n=1,446), adulthood (n=805), or lifelong (n=4,673) residence in low-income neighborhoods had LBW rates of 10.0%, 11.3%, and 10.4%, respectively; RR= 1.8 (1.1-2.8), 2.0 (1.3-3.2), and 1.9 (1.2-2.9), respectively.  Most striking, these associations tended to persist across maternal biologic and demographic status.  In multilevel logistic regression models, the adjusted (controlling for maternal birth weight, age, education, and marital status) OR of LBW for infants born to fathers with an early-life, adulthood, or lifelong residence in low (compared to lifelong residence in high) income neighborhoods equaled 1.8 (1.1-3.0), 2.0 (1.2-3.3), 1.7 (1.1-2.7) respectively.  

Conclusions.  Father’s early-life and adulthood residence in low-income neighborhoods are previously unrecognized risk factors for LBW among urban African-American mothers.  These findings strongly suggest that policy makers should address the contribution of fathers’ lifelong economic position to African-American mother’s pregnancy outcome disadvantage.

Learning Areas:

Public health or related public policy
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the contribution to paternal lifelong socioeconomic position to the pregnancy outcome of African-American women.

Keyword(s): Birth Outcomes, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an MD with an MPH and Professor in Pediatrics-Neonatology at Northwestern University. My primary research interest is in perinatal epidemiology. I have an investigational interest in understanding the social determinants of racial and ethnic group disparities in birth outcome(preterm delivery, low birth weight, neonatal and post-neonatal mortality) in the United States.I have been the principal investigator and primary author of numerous papers focusing on social determinants of the racial disparity in birth outcome.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.