Association of missing paternal demographics on infant birth certificates with perinatal risk factors for childhood obesity
Level 3 - non-randomized controlled study
Retrospective longitudinal cohort study linking birth certificates and clinical well-child records.
OpenAlex W2396233551 · doi:10.1186/s12889-016-3110-1
What was done
Researchers analyzed data from the Linked CENTURY Study, which combined birth certificates and well-child visit records for 200,258 Massachusetts children born between 1980 and 2008. Infants were categorized into three groups based on birth certificate data: pregnancies missing paternal demographic details (age, education, or race/ethnicity), pregnancies of unmarried mothers with paternal data, and pregnancies of married mothers with paternal data. Multivariable linear and logistic regression models examined associations with perinatal obesity risk factors (maternal smoking during pregnancy, gestational diabetes, birthweight, breastfeeding initiation) and weight status from 0 to 24 months (ever reaching a weight-for-length [WFL] at or above the 95th percentile or crossing upwards by two or more WFL percentiles).
What was found
Paternal data was missing in 11,989 (6.0%) birth certificates, and 31,323 (15.6%) mothers were unmarried. In adjusted analyses, missing paternal data was associated with lower birthweight (beta -0.07 kg, 95% CI: -0.08 to -0.05), higher odds of maternal smoking during pregnancy (AOR 4.40, 95% CI: 3.97 to 4.87), lower odds of breastfeeding initiation (AOR 0.39, 95% CI: 0.36 to 0.42), and higher odds of ever having a WFL at or above the 95th percentile between 0 and 24 months (AOR 1.10, 95% CI: 1.01 to 1.20). Similar, though less pronounced, associations were observed for unmarried mothers with paternal data.
Why it matters
Missing paternal information on standard birth records may serve as an easily identifiable marker of social and perinatal risk factors linked to early childhood obesity. This highlights the importance of accounting for paternal and household structural factors in early life preventive efforts.
Limits
The study is observational and cannot establish causality. Missing paternal data likely serves as a proxy for unmeasured socioeconomic disadvantage, psychosocial stress, and household instability. The dataset was drawn from a single US state, and numerical outcomes for gestational diabetes and upward WFL percentile crossing were not reported in the abstract.
Cited by
- context In the United States, approximately 10% to 11% of children have no medically acknowledged paternity on birth records.