title: Missing paternal data and adverse birth outcomes in Canada.
abstract: BACKGROUND
  Research on predictors of birth outcomes tends to focus on maternal characteristics. Less is known about the role of paternal factors. Missing paternal data on administrative records may be a marker for risk of adverse birth outcomes.
  
  
  METHODS
  Analyses were performed on a cohort of births that occurred from May 16, 2004 through May 15, 2006, which was created by linking birth and death registration data with the 2006 Canadian census. Log-binomial and binomial regression were used to estimate relative risks and risk differences for preterm birth, small-for-gestational-age birth, stillbirth and infant mortality associated with the absence of paternal information. Analyses controlled for maternal age, education, household income, parity, marital status, ethnicity and birthplace.
  
  
  RESULTS
  The analyses pertained to 135,285 singleton births. Paternal data were missing from the birth registration for 7,461 births (4.6%) and from the census data for 17,713 births (11.4%). The adjusted relative risks associated with missing paternal data on the birth registration were 1.12 (95% CI: 0.99, 1.26) for preterm birth; 1.15 (1.05, 1.26) for small-for-gestational-age birth; 1.86 (1.27, 2.73) for stillbirth; and 1.53 (1.00, 2.34) for infant mortality. Estimates were robust to varying definitions of missing paternal information, based on the birth registration, census data, or both.
  
  
  CONCLUSIONS
  This study suggests that missing paternal data is a marker for increased risk of adverse birth outcomes, over and above maternal characteristics.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec.
authors.forename: Gabriel D
authors.initials: GD
authors.lastname: Shapiro
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Tracey
authors.initials: T
authors.lastname: Bushnik
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Sheppard
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, and Department of Pediatrics, McGill University, Montreal, Quebec.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kramer
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec.
authors.forename: Seungmi
authors.initials: S
authors.lastname: Yang
keywords: Birth certificates; fetal death; infant mortality; medical record linkage; premature infant; small-for-gestational-age infant; stillbirth