title: Association of missing paternal demographics on infant birth certificates with perinatal risk factors for childhood obesity.
abstract: The role of fathers in the development of obesity in their offspring remains poorly understood. We evaluated associations of missing paternal demographic information on birth certificates with perinatal risk factors for childhood obesity.
  
  
  
  Data were from the Linked CENTURY Study, a database linking birth certificate and well-child visit data for 200,258 Massachusetts children from 1980-2008. We categorized participants based on the availability of paternal age, education, or race/ethnicity and maternal marital status on the birth certificate: (1) pregnancies missing paternal data; (2) pregnancies involving unmarried women with paternal data; and (3) pregnancies involving married women with paternal data. Using linear and logistic regression, we compared differences in smoking during pregnancy, gestational diabetes, birthweight, breastfeeding initiation, and ever recording a weight for length (WFL) ≥ the 95th percentile or crossing upwards ≥2 WFL percentiles between 0-24 months among the study groups.
  
  
  
  11,989 (6.0 %) birth certificates were missing paternal data; 31,323 (15.6 %) mothers were unmarried. In adjusted analyses, missing paternal data was associated with lower birthweight (β -0.07 kg; 95 % CI: -0.08, -0.05), smoking during pregnancy (AOR 4.40; 95 % CI: 3.97, 4.87), non-initiation of breastfeeding (AOR 0.39; 95 % CI: 0.36, 0.42), and with ever having a WFL ≥ 95th percentile (AOR 1.10; 95 % CI: 1.01, 1.20). Similar associations were noted for pregnancies involving unmarried women with paternal data, but differences were less pronounced.
  
  
  
  Missing paternal data on the birth certificate is associated with perinatal risk factors for childhood obesity. Efforts to understand and reduce obesity risk factors in early life may need to consider paternal factors.
authors.affiliation: Department of Pediatrics, Children's Health Services Research, Indiana University School of Medicine, 410 West 10th Street, Suite 2000, Indianapolis, IN, USA.
authors.forename: Erika R
authors.initials: ER
authors.lastname: Cheng
authors.affiliation: Boston College, School of Social Work, McGuinn Hall, 140 Commonwealth Avenue, Chestnut, Hill, MA, USA.
authors.forename: Summer Sherburne
authors.initials: SS
authors.lastname: Hawkins
authors.affiliation: Department of Population Medicine, Obesity Prevention Program, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401, Boston, MA, USA.
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Rifas-Shiman
authors.affiliation: Department of Population Medicine, Obesity Prevention Program, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401, Boston, MA, USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.affiliation: Department of Pediatrics, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, USA. elsie.taveras@mgh.harvard.edu.
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
mesh_terms: D000328:Adult; D001719:Birth Certificates; D001724:Birth Weight; D001942:Breast Feeding / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D016640:Diabetes, Gestational / Q000453:epidemiology; D005006:Ethnicity; D005220:Fathers / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008404:Massachusetts / Q000453:epidemiology; D039382:Maternal Nutritional Physiological Phenomena; D009035:Mothers / Q000706:statistics & numerical data; D010334:Paternity; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology
keywords: Birth certificates; Electronic health records; Health status disparities; Medical record linkage; Paternal factors; Pediatric obesity; Perinatal health