Paternal acknowledgment and term infant mortality due to unintentional injuries

Infant mortality rates due to unintentional injuries (IMR-UI) among term births to U.S.-born women exceed that of foreign-born women. Paternal acknowledgment, a proxy for paternal involvement, may be associated with risk of unintentional injuries. The relationship between paternal acknowledgment and IMR-UI among term births to U.S.-born and foreign-born women is unknown. Stratified and multivariable modified Poisson regression analyses were performed on the 2016–2017 National Center for Health Statistics (NCHS) period-linked livebirth-infant death dataset of singleton, term births to U.S.-born and foreign-born women. Paternal acknowledgment was ascertained by being named on their infant’s birth certificate. The primary outcome was IMR-UI per 100,000 live-births. Among U.S.-born women, IMR-UI for term births with non-acknowledged fathers (n = 513,341) exceeded that of term births with acknowledged fathers (n = 3,796,315): 91.75/100,000 versus 30.05/100,000, respectively; RR (95% CI) = 3.00 (2.69, 3.34). Among foreign-born women, IMR-UI for term births with non-acknowledged fathers (n = 51,917) equaled 25.09/100,000 compared to 9.24/100,000 for term births with acknowledged fathers (n = 629,204), RR (95% CI) = 2.71 (1.49, 4.95). The adjusted RR (95% CI) of first-year mortality due to unintentional injuries for term births to non-Latina Black, non-Latina White, and Mexican-American U.S.-born women with non-acknowledged (versus acknowledged) fathers equaled 1.24 (1.04, 1.49), 1.28 (1.08, 1.52), and 1.15 (0.68, 1.94), respectively. Paternal non-acknowledgment is associated with infant mortality due to unintentional injuries among term births to U.S.-born and foreign-born women. What is already known on this topic? Infant mortality rates due to unintentional injuries (IMR-UI) are greater among term births to U.S.-born (compared to foreign-born) women. Paternal non-acknowledgment, a proxy for paternal non-involvement, is associated with all-cause term infant mortality. What does this study add? Paternal non-acknowledgment is associated with infant mortality due to unintentional injuries among term births to U.S.-born and foreign-born women. This phenomenon is particularly noteworthy for U.S.-born non-Latina Black and White women.