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Association of preconception paternal health on perinatal outcomes: analysis of U.S. claims data
Alex M Kasman1, Chiyuan A Zhang1, Shufeng Li1
1Department of Urology, Stanford University, Stanford, California.
Insights
Paternal health issues, like metabolic syndrome, are linked to increased risks of preterm birth, low birth weight, and neonatal intensive care unit stays for infants. Both parents' health impacts pregnancy outcomes.
Area of Science:
- Reproductive Health
- Public Health
- Genetics
Background:
- Paternal health is increasingly recognized as a factor influencing pregnancy outcomes.
- Existing research has primarily focused on maternal health, with less attention paid to the father's role.
- Understanding the impact of paternal health can lead to more comprehensive preconception care strategies.
Purpose of the Study:
- To investigate the association between paternal health status and maternal peripartum and neonatal outcomes.
- To determine if paternal comorbidities, such as metabolic syndrome, correlate with adverse pregnancy results.
Main Methods:
- Retrospective cohort study utilizing healthcare claims data from the IBM Marketscan Research database (2009-2016).
- Inclusion of singleton live births with paired paternal and maternal health records.
- Analysis of paternal diagnoses (metabolic syndrome, chronic diseases) and their correlation with outcomes like preterm birth and low birth weight.
Main Results:
- Paternal comorbidities were associated with higher odds of preterm birth, low birth weight (LBW), and neonatal intensive care unit (NICU) stay.
- Fathers with metabolic syndrome components showed a 19% increased odds of preterm birth, 23% for LBW, and 28% for NICU stay.
- Maternal morbidity, including gestational diabetes and preeclampsia, was positively associated with preconception paternal health.
Conclusions:
- Increased paternal comorbidity before conception may negatively impact infant and maternal outcomes.
- While the paternal effect is modest, it underscores the importance of both parents' health for a healthy pregnancy.
- Findings suggest incorporating paternal health assessments into preconception counseling and care.
Objective:
To assess whether paternal health is associated with maternal peripartum and neonatal outcomes.
Design:
Retrospective cohort study.
Setting:
University research departments.
Patient(S):
Analytic sample of children born to paired fathers and mothers covering live births within the United States between 2009-2016.
Intervention(S):
Paternal health status (e.g., metabolic syndrome diagnoses, individual chronic disease diagnoses).
Main Outcome Measure(S):
Primary outcome of preterm birth (i.e., live birth before 37 weeks), and secondary outcomes of low birth weight, neonatal intensive care unit (NICU) stay, gestational diabetes, preeclampsia, eclampsia, and length of maternal stay.
Result(S):
The IBM Marketscan Research database covers reimbursed health care claims data on inpatient and outpatient encounters who are privately insured through employment-sponsored health insurance. We assessed 785,809 singleton live births, with 6.6% born preterm. The presence of paternal comorbidities was associated with higher odds of preterm birth, low birth weight (LBW), and NICU stay. After adjusting for maternal factors, fathers with most or all components of the metabolic syndrome had 19% higher odds of having a child born preterm (95% CI 1.11-1.28), 23% higher odds of LBW (95% CI 1.01-1.51), and 28% higher odds of NICU stay (95% CI 1.08-1.52). Maternal morbidity (e.g., gestational diabetes or preeclampsia) was also positively associated with preconception paternal health.
Conclusion(S):
Increased preconception paternal comorbidity may be associated with negative infant and maternal outcomes. Although the paternal effect remains modest, these findings highlight the importance of the health of both parents, particularly the mother, on healthy pregnancy.
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