Father’s Lifetime Socioeconomic Status, Small for Gestational Age Infants, and Infant Mortality: A Population-Based Study

Abstract

Objective: To ascertain the association between father’s lifetime socioeconomic status (SES) and rates of small for gestational age (SGA, defined as weight for gestational age <10th percentile) and infant mortality (defined as <365 days).Methods: The study sample was limited to the singleton births of African American (n=8,331), non-Latina White (n=18,200), and Latina (n=2,637) women. Strati­fied and multilevel, multivariable logistic regression analyses were conducted on the Illinois transgenerational dataset of infants (1989-1991) and their Chicago-born par­ents (1956-1976) with appended US census income data (n=29,168). The median fam­ily income of father’s census tract residence during childhood and parenthood were used to assess lifetime SES.Results: Births (n=8,113) to fathers with a lifetime low SES had a SGA rate of 13.3% compared with 6.6% for those (n=10,329) born to fathers with a lifetime high SES, RR = 1.97 (1.79, 2.17). The infant mortality rate of births to fathers with a lifetime low SES exceeded that of infant mortality rate of births to fathers with a lifetime high SES: 13/1,000 vs 5/1,000, respectively; RR = 2.71 (1.94, 3.77). The adjusted (controlling for mother’s age, education, marital status, and race/ethnicity) OR of SGA for fathers with childhood, parenthood, and lifetime low (vs high) SES were 1.15 (1.01, 1.31), 1.13 (1.02, 1.26), and 1.19 (1.05, 1.34), respectively. The adjusted OR of infant mor­tality for births to fathers with childhood, parenthood, and lifetime low (vs high) SES were 1.14 (.78, 1.67), 1.40 (.90, 2.18), and 1.31 (.90, 1.92), respectively.Conclusions: Low paternal socioeconomic status is a previously unrecognized determi­nant of SGA birth regardless of mother’s de­mographic status.Ethn Dis. 2019;29(1):9-16; doi:10.18865/ed.29.1.9

A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms

“…Most of these studies were conducted in the United States (both north and south) [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. We also included six studies conducted in Europe and the United Kingdom [ 50 , 51 , 52 , 53 , 54 , 55 ].…”

“…Our selection includes a diverse range of study designs. While a majority are cohort studies [ 29 , 31 , 35 , 37 , 38 , 42 , 44 , 45 , 50 , 54 , 57 , 58 ], others are birth record or population-based [ 30 , 32 , 36 , 39 , 39 , 40 , 51 ], cross-sectional [ 26 , 28 , 33 , 34 , 41 , 43 , 46 , 47 , 48 , 52 , 53 , 56 , 59 ], ecological [ 49 ] and case-control [ 55 ] studies.…”

“…Several investigated LBW and subtypes [ 29 , 32 , 37 , 38 , 39 , 41 , 45 , 50 , 51 , 53 , 56 , 57 ], while others investigated PTB and subtypes [ 28 , 31 , 33 , 34 , 36 , 37 , 38 , 39 , 40 , 42 , 44 , 46 , 47 , 50 , 51 , 54 ]. Lastly, some studies investigated SGA [ 26 , 28 , 30 , 38 , 46 , 50 , 52 , 58 ].…”

“…This approach is now acknowledged as the gold standard for assessing the true health-related contextual effect [ 46 ]. However, most of the studies applied more classical multivariate regressions, such as logistic, binomial, and multinomial regression [ 32 , 37 , 38 , 40 , 41 , 42 , 43 , 44 , 46 , 47 , 48 , 50 , 51 , 52 , 54 , 55 , 56 , 57 , 58 , 59 ], while just five studies performed multilevel analysis [ 26 , 30 , 33 , 34 , 35 ]. Two studies tested the mediation hypothesis using a structural equation model [ 44 , 45 ].…”

“…Levels and characteristics of socioeconomic inequality differ between studies, depending on the data used. Some authors relied on individual socioeconomic or socio-demographic characteristics alone [ 26 , 29 , 31 , 37 , 38 , 44 , 47 , 50 , 52 , 54 , 55 , 58 ], such as maternal education level [ 26 , 31 , 32 , 33 , 34 , 35 , 37 , 38 , 39 , 42 , 43 , 44 , 45 , 47 , 48 , 50 , 52 , 54 , 55 , 56 , 57 , 58 ], paternal education level [ 34 , 38 , 52 ], employment [ 37 , 55 , 58 ], income [ 26 , 38 , 46 ], etc. Others used neighborhood socioeconomic characteristics only [ 28 , 30 , 51 , 53 ], such as neighborhood income index [ 28 , 30 , 32 , 35 ,…”