Infant Mortality Rates of Non-Hispanic White and African-American Term Births: The Effect of Acknowledged Fathers'...

To determine the extent to which acknowledged fathers' education attainment is associated with the infant mortality rate of term births to African-American and non-Hispanic White women. We hypothesized that African American (compared to non-Hispanic White) term births would have a greater percentage of first-year deaths attributable to low paternal education attainment.

Stratified and multivariable regression analyses were performed on the 2018-2019 National Center for Health Statistics US cohort-linked live birth-infant death data files. Only term (37-42 weeks) singleton births to non-Hispanic White (n = 2,937,995) and African-American (n = 508,374) U.S.-born women with acknowledged fathers and a non-missing value for paternal education were included.

Paternal low education attainment was higher among births to African-American women compared to non-Hispanic White women. In both races, infant mortality rates decreased with higher levels of paternal education attainment. When controlling for traditional maternal risk factors, the relative risk of infant mortality for births to fathers with < 12 years of education compared to a bachelor's degree or higher equaled 1.59 (1.18-2.14) and 1.55 (1.35-1.77) for African-American and non-Hispanic White births, respectively. A greater percentage of term infant mortality was attributable to low paternal education attainment (< 12 years) in births to African-American (compared to non-Hispanic White) women (6.5% vs. 5.4%).

Acknowledged fathers' education attainment is a determinant of term infant first-year mortality.