Abstract
Objective
To determine the proportion of small for gestational age (weight < 10th percentile, SGA) births among fathers with lifelong low (compared to high) socioeconomic position (SEP) attributable to white and African-American women’s unhealthy pregnancy-related behaviors.
Methods
Oaxaca-Blinder decomposition methods were conducted on the Illinois transgenerational dataset of infants (1989–1991) and their Chicago-born parents (1956–1976) with appended US census income data. The neighborhood income of father’s residence at the time of his birth and at the time of his infant’s birth were used to estimate his lifetime SEP. Maternal unhealthy pregnancy-related behaviors were defined as cigarette smoking, inadequate prenatal care, and/or low weight gain during pregnancy.
Results
Among African-American women, births (n = 4426) to fathers with lifetime low SEP had an SGA rate of 14.8% compared to 12.1% for those (n = 365) born to fathers with lifetime high SEP (p < 0.0001). Among white women, births (n = 1430) to fathers with lifetime low SEP had an SGA rate of 9.8% compared to 6.2% for those (n = 9141) born to fathers with lifetime high SEP (p < 0.0001). Adjusting for maternal age, marital status, education, and parity, African-American and white women’s unhealthy pregnancy behaviors accounted for 25% and 33%, respectively, of the disparity in SGA rates among infants of lifetime low (compared to high) SEP fathers.
Conclusion
A significant proportion of the disparity in SGA rates between fathers with lifelong low (compared to high) SEP is explained in both races by maternal unhealthy pregnancy behaviors.
Significance
What is already known on this subject? An expanding published literature show that father’s low socioeconomic position (SEP) is a risk factor for adverse birth outcome, including small for gestational age (< 10th percentile, SGA) births, independent of maternal demographic characteristics. Mechanisms underlying this association remain unclear.
What this study adds? This study identified maternal unhealthy pregnancy behaviors (including cigarette smoking, inadequate prenatal care, and low pregnancy weight gain) as factors which explain a substantial proportion of the disparity in SGA rates between infants of low (compared to high) SEP fathers.
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Data Availability
Data are available upon request.
Code Availability
Descriptive analyses were completed using SAS version 9.4 (SAS Institute, Cary, NC), and the Oaxaca decomposition analyses were performed in Stata SE version 12 (StataCorp LP, College Station, TX) using the Oaxaca add-on command.
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Funding
Provided by March of Dimes Foundation, Grant No. 21-FY16-111.
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SDH conceptualized the study and drafted the initial manuscript and subsequent revisions. RC conceptualized the study and drafted the initial manuscript. CD performed data analyses and critically reviewed the manuscript. JWC conceptualized and designed the study, oversaw all aspects of the study, and reviewed and revised the manuscript.
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The institutional review board of Ann & Robert H. Lurie Children’s Hospital of Chicago approved the investigational protocol.
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Hibbs, S.D., Carroll, R.C., DeSisto, C. et al. Explaining the Link Between Paternal Socioeconomic Position and Small for Gestational Age Birth: The Effect of Maternal Unhealthy Behaviors. Matern Child Health J 27, 1898–1903 (2023). https://doi.org/10.1007/s10995-023-03686-5
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DOI: https://doi.org/10.1007/s10995-023-03686-5