Dads also matter: paternal and maternal factors associated with infant injury mortality

Despite advances in injury prevention, trauma remains a leading cause of infant mortality in the USA. This study sought to compare maternal characteristics with paternal risk factors for injury-related mortality for infants.

Data were collected from state-compiled birth and infant death records in the National Vital Statistics System and disaggregated by maternal and paternal characteristics, including education, age and paternity acknowledgement if mother was unmarried. Injury-related causes were defined using International Classification of Diseases, 10th Revision codes. Crude rates were calculated per 1000 infants. Logistic regressions for paternal and maternal characteristics, individually and comparatively, were conducted.

From 2017 to 2021, 8191 infants out of 18 672 691 births died from external causes. For both mothers and fathers, each additional 5 years of age was significantly associated with greater odds of infant trauma mortality (p<0.001). Compared with having a middle school education or less, having a bachelor's degree was associated with almost a 70% reduction in infant trauma mortality for both mothers (OR 0.31, 95% CI 0.21 to 0.45, p<0.001) and fathers (OR 0.29, 95% CI 0.18 to 0.47, p<0.001). Compared with mothers, fathers who had the same level of education were 30% less likely to have an infant die of trauma (OR 0.70, 95% CI 0.65 to 0.75, p<0.001). If the mother was unmarried, injury-related infant death rates (DRs) were twice as high among infants without paternity acknowledgement (DR=1.45) compared with those that did (DR=0.72).

Fathers' and mothers' characteristics, including age and education, correlate with infant trauma mortality. Interventions should incorporate both parents to improve birth outcomes.