The Association of Paternal Race and Ethnicity with Adverse Pregnancy Outcomes in a Contemporary U.S. Cohort.
The Association of Paternal Race and Ethnicity with Adverse Pregnancy Outcomes in a Contemporary U.S. Cohort.
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当代美国队列中父亲种族和民族与不良妊娠结果的关联。
DOI：
10.1055/s-0039-3400995
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发表时间：
2021
影响因子：
2
通讯作者：
Egede,LeonardE
中科院分区：
文献类型：
--
作者：
Palatnik,Anna;Garacci,Emma;Walker,RebekahJ;Ozieh,MukosoN;Williams,JoniS;Egede,LeonardE
目的母亲的种族和民族差异在产科结果中存在。父亲种族和民族对产科结果的影响尚无充分记录。本研究的目的是调查父亲种族和民族与几种不良妊娠结局之间的关联。研究设计这是来自 CDC 国家生命统计数据的 2013 年至 2017 年出生数据的回顾性队列。所有单胎活产均纳入分析。缺少父系种族和民族的记录被排除在外。主要因变量是以下不良孕产妇和围产期结局：妊娠糖尿病、妊娠高血压疾病、早产<37周、剖腹产、低出生体重<2,500克、5分钟阿普加评分<7、入住新生儿重症监护病房（NICU）以及出生后6小时辅助通气。主要暴露的是父系种族和民族，分为非西班牙裔白人、非西班牙裔黑人、西班牙裔等。其他种族和民族类别包括：美洲印第安人、阿拉斯加原住民、亚洲人、夏威夷原住民或其他太平洋岛民。通过单变量和多变量分析来确定父亲种族和民族是否与不良妊娠结局独立相关。结果总共纳入了 16,482,745 名新生儿。在单变量分析中，所有不良产科结局均与父亲种族和民族显着相关。在多变量分析中，控制了母亲和父亲的人口统计特征以及母亲的临床因素，父亲的种族和民族仍然与大多数不良妊娠结局显着相关。最强的关联是：（1）父亲为非西班牙裔黑人种族和种族，以及较高的低出生体重和早产率（比值比[OR] = 1.25，95% CI：1.24–1.27，OR = 1.14，95% CI：1.13–1.15）； (2) 父亲为西班牙裔和族裔，5分钟阿普加评分<7的比例较低，且出生后6小时以上接受辅助通气的比例较低（分别为OR = 0.78，95% CI：0.77–0.79，OR = 0.77，95% CI：0.75–0.78）； (3) 其他父亲种族和民族，妊娠期糖尿病发病率较高，但妊娠期高血压疾病和出生后 6 小时以上辅助通气的发病率较低（OR = 1.26，95% CI：1.25–1.27；OR = 0.79，95% CI：0.78–0.80；和OR = 0.80，95% CI：分别为 0.78–0.82）。所有关联均与父亲的非西班牙裔白人种族和民族进行比较。结论父亲的种族和民族与不良产科结局具有独立关联。父亲种族影响的途径和程度尚未完全了解，值得进一步研究。
ObjectiveMaternal racial and ethnic disparities exist in obstetric outcomes. The contribution of paternal race and ethnicity toward obstetric outcomes has been less well documented. The objective of this study was to investigate the association between paternal race and ethnicity and several adverse pregnancy outcomes.Study DesignThis was a retrospective cohort of birth data from the CDC National Vital Statistics, years 2013—2017. All singleton live births were included in the analysis. Records with missing paternal race and ethnicity were excluded. The primary dependent variables were the following adverse maternal and perinatal outcomes: gestational diabetes, hypertensive disorder of pregnancy, preterm birth <37 weeks, cesarean delivery, low birth weight <2,500 g, 5-minute Apgar's score <7, admission to neonatal intensive care unit (NICU), and assisted ventilation at > 6 hours of life. The main exposure was paternal race and ethnicity, which was grouped into non-Hispanic white, non-Hispanic black, Hispanic, and other. Other race and ethnicity category included: American Indian, Alaskan Native, Asian, Native Hawaiian, or other Pacific Islander. Univariable and multivariable analyses were done to determine whether paternal race and ethnicity was independently associated with adverse pregnancy outcomes.ResultsA total of 16,482,745 births were included. In univariable analysis, all adverse obstetric outcomes were significantly associated with paternal race and ethnicity. In multivariable analysis, controlling for maternal and paternal demographic characteristics and maternal clinical factors, paternal race and ethnicity remained significantly associated with the majority of the adverse pregnancy outcomes. The strongest association was seen with: (1) paternal non-Hispanic black race and ethnicity, and higher rates of LBW and preterm birth (Odds ratio [OR] = 1.25, 95% CI: 1.24–1.27 and OR = 1.14, 95% CI: 1.13–1.15, respectively); (2) paternal Hispanic race and ethnicity and lower rates of 5-minute Apgar's score <7, and assisted ventilation at >6 hours of life (OR = 0.78, 95% CI: 0.77–0.79, and OR = 0.77, 95% CI: 0.75–0.78, respectively); and (3) other paternal race and ethnicity and higher rates of gestational diabetes, but lower rates of hypertensive disorder of pregnancy and assisted ventilation >6 hours of life (OR = 1.26, 95% CI: 1.25–1.27; OR = 0.79, 95% CI: 0.78–0.80; and OR = 0.80, 95% CI: 0.78–0.82, respectively). All associations were in comparison to paternal non-Hispanic white race and ethnicity.ConclusionPaternal race and ethnicity has an independent association with adverse obstetric outcomes. The pathway and the extent of the paternal racial influence are not fully understood and deserve additional research.