Age-related patterns of preterm birth (<37 weeks, PTB) rates among African-American and non-Hispanic White mothers: The effect of paternal involvement

Background: A limited literature shows that PTB rates decline with advancing age among 15-35 year old White mothers. For unclear reasons, a similar pattern fails to occur among African-Americans.

Objective: To assess the extent to which paternal involvement modifies the relationship between maternal age and PTB rates among African-American and non-Hispanic White mothers.

Methods: Stratified and multivariable logistic regression analyses were performed on an Illinois transgenerational dataset with appended US census income information of infants (1989-1991) and their mothers (1956-1976). Using information listed on infants' birth certificates, paternal involvement was categorized as unmarried with father not named (uninvolved), unmarried but father named (partially involved), or married (involved).

Results: In Cook County IL, among African-American mothers (n=39,991) with uninvolved fathers and lifelong residence in lower income neighborhoods, PTB rates increased from 18.8% for teens to 21.5% for 30-35 year-olds (p=0.006). Most striking, among African-Americans with involved fathers and lifelong residence in lower income neighborhoods, PTB rates decreased from 16.4% for teens to 12.5% for 30-35 year-olds. Interestingly, among African-Americans with uninvolved fathers and lifelong residence in higher income neighborhoods, PTB rates rose from 16% for teens to 25% for 30-35 year-olds. White mothers (n=31,981) did not demonstrate “weathering” regardless of paternal involvement and neighborhood income.

Conclusions: Paternal involvement, or something closely related to it, reverses the weathering pattern of rising PTB rates with advancing age among African-American mothers, independent of neighborhood income. Greater research and public health attention to the contribution of fathers to the racial disparity in PTB rates is warranted.