Paternal involvement in pregnancy reduces infant deaths

Benefit for infants born to black women may be greatest, study suggests

Studies have shown fathers who are active in their children's upbringing can significantly benefit their children's early development, academic achievement and well being. Now, a new study by University of South Florida researchers suggests that a father's involvement before his child is born may play an important role in preventing death during the first year of life - particularly if the infant is black.

The USF team sought to evaluate whether the absence of fathers during pregnancy contributes to racial and ethnic disparities in infant survival and health. Their findings were recently reported online in the Journal of Community Health.

"Our study suggests that lack of paternal involvement during pregnancy is an important and potentially modifiable risk factor for infant mortality," concluded the study's lead author Amina Alio, PhD, research assistant professor of community and family health at the USF College of Public Health. "A significant proportion of infant deaths could be prevented if fathers were to become more involved."

The researchers examined the records of all births in Florida from 1998 to 2005 - more than 1.39 million live births. Father involvement was defined by the presence of the father's name on the infant's birth certificate. While this measure does not assess the extent or quality of a father's involvement during pregnancy, other studies have established a link between paternal information on a birth record and prenatal paternal involvement.

Among the study's findings:

• Infants with absent fathers were more likely to be born with lower birth weights, to be preterm and small for gestational age.

• Regardless of race or ethnicity, the neonatal death rate of father-absent infants was nearly four times that of their counterparts with involved fathers.

• The risk of poor birth outcomes was highest for infants born to black women whose babies' fathers were absent during their pregnancies. Even after adjusting for socioeconomic differences, these babies were seven times more likely to die in infancy than babies born to Hispanic and white women in the same situation.
• Obstetric complications contributing to premature births, such as anemia, chronic high blood pressure, eclampsia and placental abruption, were more prevalent among women whose babies' fathers were absent during pregnancy.

• Expectant mothers in the father-absent group tended to be younger, more educated, more likely to never have given birth, more likely to be black, and had a higher percentage of risk factors like smoking and inadequate prenatal care than mothers in the father-involved group.

Paternal support may decrease the mother's emotional stress, which has been linked to poor pregnancy outcomes, or promote healthy prenatal behavior, Dr. Alio suggested. For instance, some studies, including USF's, indicate that pregnant women with absent partners are more likely to report smoking during pregnancy and get inadequate prenatal care. Barriers to expectant fathers' involvement in the lives of their pregnant partners, including issues like unemployment, relationship status, and participation in prenatal visits, must be examined to increase the role of men during pregnancy, she said.

Improving the involvement of expectant fathers holds promise for reducing costly medical treatments for the complications of premature births as well as reducing infant mortality rates, particularly in black communities, Dr. Alio said. "When fathers are involved, children thrive in school and in their development. So, it should be no surprise that when fathers are present in the lives of pregnant mothers, babies fare much better."

Dr. Alio was recently named a member of the Joint Center for Political and Economic Studies' National Commission on Paternal Involvement in Pregnancy Outcomes.