The Role of Father Involvement during Pregnancy in the Prevention of Adverse Pregnancy Outcomes Public
Miller, Angela Milton (2013)
Published
Abstract
Preterm birth, defined as any live birth before 37 completed
weeks of gestation, is a leading cause of infant morbidity and
mortality.
Rates of preterm birth in the United States are much higher
than in both developed and developing nations. Traditional risk
markers
account for only 25-30% of occurrences of preterm birth.
Paternal involvement has been extensively studied in relation
to child development, but little attention has been paid to the
role of
fathers in reduction of adverse pregnancy outcomes. However,
paternal involvement, as determined by presence of the
father's
name on the birth certificate, has been observed to be a
predictor of both infant morbidity and mortality. The mechanism by
which
missing paternal demographics are associated with pregnancy
outcomes is unknown.
The literature is limited by vague measurements of
paternal involvement and limited understanding of the mechanism
through which
paternal involvement acts to affect pregnancy outcomes.
Thus, the overall theme of this dissertation proposal is to explore
the
concept of "paternal involvement", particularly as it
applies to pregnancy outcomes.
Mothers and fathers with at least a friendly relationship
appear to give similar reports of father involvement, though
fathers report
higher levels of paternal involvement than mothers. Use of
mothers' interviews may be a reasonable approach to assess
paternal
involvement, though findings can be applied only to fathers
who are both accessible and willing to participate in
studies.
In cohabiting couples, moderate or low paternal involvement
may confer greater risk of preterm birth compared to high
paternal
involvement. Future research should explore the joint impact
of relationship status and father involvement.
Contrary to a priori hypotheses, pregnant women with
psychiatric illness may experience a non-significant increased risk
of
preterm birth despite high levels of partner support. This
finding may indicate a more complicated relationship between
women
and their partners during pregnancy.
Future studies of father involvement and pregnancy outcomes
should focus on further development of measures of father
involvement during pregnancy, and place increased emphasis on
recruiting mothers and fathers not in relationships.
Table of Contents
Table of Contents
List of Tables
...................................................................................................................
ix
List of Figures
.................................................................................................................
xi
Introduction
.........................................................................................................................
1
Chapter 1: Epidemiology of Preterm Birth
.........................................................................
3
Preterm Birth
..................................................................................................................
4
Mechanisms for preterm birth
........................................................................................
6
Known Risk Factors for Preterm Birth
...........................................................................
6
Genetics and Heritability in Preterm Birth
....................................................................
14
Conclusion
......................................................................................................................
15
Chapter 2: The Role of Fathers during Pregnancy and Pregnancy
Outcomes .................. 17
Abstract
..........................................................................................................................
18
Introduction
..................................................................................................................
20
Racial Disparities in Pregnancy Outcomes
...................................................................
20
Father's Biological Impact on Pregnancy Outcomes
.................................................... 22
Father Involvement in Pregnancy
.................................................................................
24
Measuring Father Involvement
......................................................................................
31
Barriers to Unmarried Father Involvement
..................................................................
32
Limitations of the Current Literature
...........................................................................
34
Recommendations
........................................................................................................
35
Conclusion
.....................................................................................................................
36
Chapter 3: Agreement between Maternal and Paternal Reports of
Prenatal Father Involvement
...........................................................................................................................................
49
Abstract
.........................................................................................................................
50
Introduction
...................................................................................................................
51
Methods
.........................................................................................................................
52
Results
...........................................................................................................................
55
Discussion
.....................................................................................................................
58
Conclusion
.....................................................................................................................
62
Chapter 4: Father Involvement and Preterm Birth in the Fragile
Families and Child Wellbeing
Study
.................................................................................................................................
78
Abstract
.........................................................................................................................
79
Introduction
..................................................................................................................
80
Methods
..........................................................................................................................
81
Results
...........................................................................................................................
83
Discussion
.....................................................................................................................
85
Conclusion
.....................................................................................................................
89
Chapter 5: Partner Support during Pregnancy and Risk of Preterm
Birth ...................... 97
Abstract
.........................................................................................................................
98
Introduction
..................................................................................................................
99
Methods
.......................................................................................................................
100
Results
..........................................................................................................................103
Discussion
...................................................................................................................
106
Conclusion
...................................................................................................................
108
Chapter 6: The Dissertation in Context
..........................................................................
120
Contribution of Dissertation to Scientific Knowledge
................................................. 123
Future Directions
.........................................................................................................
124
References
........................................................................................................................125
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