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Paternal race/ethnicity and risk of adverse birth outcomes in the United States, 1989–2013

1 Department of Epidemiology, Brown University, USA
2 Department of Epidemiology and Biostatistics, Michigan State University, USA
3 Department of Sociology, Michigan State University, USA

Objectives: Investigate adverse birth outcomes in the United States (US) from 1989–2013 in relation to paternal and maternal race/ethnicity. Design: We used US natality data for singleton births to women 15–44 with information on birthweight, gestational age, and covariates (n = 90,771,339). We calculated unadjusted and adjusted probabilities of preterm birth (PTB, < 37 weeks gestation) and small for gestational age (SGA, < 10th percentile) among all combinations of maternal and paternal race/ethnicity: non-Hispanic black (NHB), non-Hispanic white (NHW), Hispanic, and Asian, and where paternal race/ethnicity was missing. Results: Missing, followed by NHB, paternal race/ethnicity had the two highest risks of PTB within each maternal racial/ethnic group. Asian, followed by NHW, paternal race/ethnicity had the two lowest risks of PTB. For SGA, however, Asian, followed by missing, paternal race/ethnicity had the two highest risks, and NHW race/ethnicity had the lowest risk. Our findings also demonstrate effect modification on the additive scale, with missing and NHB paternal race/ethnicity conferring a larger increase in risk of PTB for NHB women compared to women of other race/ethnicity groups. Conclusions: These data confirm US disparities in adverse birth outcomes by maternal and paternal race/ethnicity and argue for increased resources and interventions in response.
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Keywords preterm birth; paternal race/ethnicity; small for gestational age; mixed-race couple; adverse birth outcomes

Citation: Yu Li, Zhehui Luo, Claudia Holzman, Hui Liu, Claire E. Margerison. Paternal race/ethnicity and risk of adverse birth outcomes in the United States, 1989–2013. AIMS Public Health , 2018, 5(3): 312-323. doi: 10.3934/publichealth.2018.3.312

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