Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
ORISE Fellow, Research Participation Program, Centers for Disease Control and Prevention, Administered by the Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
Public Health Rep. 2020 Mar-Apr;135(2):253-261. doi: 10.1177/0033354920904066. Epub 2020 Feb 4.
Paternal involvement is associated with improved infant and maternal outcomes. We compared maternal behaviors associated with infant morbidity and mortality among married women, unmarried women with an acknowledgment of paternity (AOP; a proxy for paternal involvement) signed in the hospital, and unmarried women without an AOP in a representative sample of mothers in the United States from 32 sites.
We analyzed 2012-2015 data from the Pregnancy Risk Assessment Monitoring System, which collects site-specific, population-based data on preconception, prenatal and postpartum behaviors, and experiences from women with a recent live birth. We calculated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) to examine associations between level of paternal involvement and maternal perinatal behaviors.
Of 113 020 respondents (weighted N = 6 159 027), 61.5% were married, 27.4% were unmarried with an AOP, and 11.1% were unmarried without an AOP. Compared with married women and unmarried women with an AOP, unmarried women without an AOP were less likely to initiate prenatal care during the first trimester (married, aPR [95% CI], 0.94 [0.92-0.95]; unmarried with AOP, 0.97 [0.95-0.98]), ever breastfeed (married, 0.89 [0.87-0.90]; unmarried with AOP, 0.95 [0.94-0.97]), and breastfeed at least 8 weeks (married, 0.76 [0.74-0.79]; unmarried with AOP, 0.93 [0.90-0.96]) and were more likely to use alcohol during pregnancy (married, 1.20 [1.05-1.37]; unmarried with AOP, 1.21 [1.06-1.39]) and smoke during pregnancy (married, 3.18 [2.90-3.49]; unmarried with AOP, 1.23 [1.15-1.32]) and after pregnancy (married, 2.93 [2.72-3.15]; unmarried with AOP, 1.17 [1.10-1.23]).
Use of information on the AOP in addition to marital status provides a better understanding of factors that affect maternal behaviors.
父亲的参与与改善婴儿和产妇的结局有关。我们比较了已婚妇女、在医院签署了承认父亲身份的未婚妇女（代表父亲参与）以及没有签署承认父亲身份的未婚妇女在代表美国 32 个地点的母亲中与婴儿发病率和死亡率相关的产妇行为。
我们分析了 2012 年至 2015 年来自妊娠风险评估监测系统的数据，该系统从受孕前、产前和产后行为以及最近分娩的女性的经历方面收集特定地点的基于人群的数据。我们计算了调整后的患病率比（aPR）和 95%置信区间（CI），以检查父亲参与程度与产妇围产期行为之间的关联。
在 113020 名受访者（加权 N=6159027）中，61.5%已婚，27.4%未婚但有承认父亲身份的协议，11.1%未婚且没有承认父亲身份的协议。与已婚妇女和有承认父亲身份的未婚妇女相比，没有承认父亲身份的未婚妇女在孕早期开始产前护理的可能性较小（已婚妇女 aPR[95%CI]为 0.94[0.92-0.95]；有承认父亲身份的未婚妇女 aPR[95%CI]为 0.97[0.95-0.98]），母乳喂养的可能性较小（已婚妇女 aPR[95%CI]为 0.89[0.87-0.90]；有承认父亲身份的未婚妇女 aPR[95%CI]为 0.95[0.94-0.97]），母乳喂养至少 8 周的可能性较小（已婚妇女 aPR[95%CI]为 0.76[0.74-0.79]；有承认父亲身份的未婚妇女 aPR[95%CI]为 0.93[0.90-0.96]），在怀孕期间使用酒精的可能性较大（已婚妇女 aPR[95%CI]为 1.20[1.05-1.37]；有承认父亲身份的未婚妇女 aPR[95%CI]为 1.21[1.06-1.39]）和怀孕期间吸烟的可能性较大（已婚妇女 aPR[95%CI]为 3.18[2.90-3.49]；有承认父亲身份的未婚妇女 aPR[95%CI]为 1.23[1.15-1.32]）以及产后吸烟的可能性较大（已婚妇女 aPR[95%CI]为 2.93[2.72-3.15]；有承认父亲身份的未婚妇女 aPR[95%CI]为 1.17[1.10-1.23]）。
除了婚姻状况外，使用承认父亲身份的协议信息可以更好地了解影响产妇行为的因素。
