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Impact of a Federal Healthy Start Program on Feto-infant Morbidity Associated with Absent Fathers: A Quasi-experimental Study

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Abstract

The absence of fathers during pregnancy increases the risk of feto-infant morbidities, including low birth weight (LBW), preterm birth (PTB), and small-for-gestational age. Previous research has shown that the Central Hillsborough Healthy Start project (CHHS)—a federally funded initiative in Tampa, Florida—has improved birth outcomes. This study explores the effectiveness of the CHHS project in ameliorating the adverse effects of fathers’ absence during pregnancy. This retrospective cohort study used CHHS records linked to vital statistics and hospital discharge data (1998–2007). The study population consisted of women who had a singleton birth with an absent father during pregnancy. Women were categorized based on residence in the CHHS service area. Propensity score matching was used to match cases (CHHS) to controls (rest of Florida). Conditional logistic regression was employed to generate odds ratios (OR) and 95 % confidence intervals (CI) for matched observations. Women residing in the CHHS service area were more likely to be high school graduates, black, younger (<35 years), and to have adequate prenatal care compared to controls (p < 0.01). These differences disappeared after propensity score matching. Mothers with absent fathers in the CHHS service area had a reduced likelihood of LBW (OR 0.76, 95 % CI 0.65–0.89), PTB (OR 0.72, 95 % CI 0.62–0.84), very low birth weight (OR 0.50, 95 % CI 0.35–0.72) and very preterm birth (OR 0.48, 95 % CI 0.34–0.69) compared to their counterparts in the rest of the state. This study demonstrates that a Federal Healthy Start project contributed to a significant reduction in adverse fetal birth outcomes in families with absent fathers.

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Acknowledgments

This work was partly supported by a grant from the Health Resource Service Administration (HRSA), Maternal Child Health Bureau (Grant No. H49MC12793).

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs, MDC56, Tampa, FL, 33612, USA

    Hamisu M. Salihu, Euna M. August & Alfred K. Mbah

  2. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, FL, USA

    Hamisu M. Salihu

  3. Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA

    Euna M. August

  4. Department of Community and Preventive Medicine, University of Rochester, Rochester, NY, USA

    Amina P. Alio

  5. REACHUP, Incorporated, Tampa, FL, USA

    Estrellita Lo Berry

  6. Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA

    Muktar H. Aliyu

Authors
  1. Hamisu M. Salihu
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  2. Euna M. August
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  3. Alfred K. Mbah
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  4. Amina P. Alio
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  5. Estrellita Lo Berry
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  6. Muktar H. Aliyu
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Correspondence to Hamisu M. Salihu.

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Salihu, H.M., August, E.M., Mbah, A.K. et al. Impact of a Federal Healthy Start Program on Feto-infant Morbidity Associated with Absent Fathers: A Quasi-experimental Study. Matern Child Health J 18, 2054–2060 (2014). https://doi.org/10.1007/s10995-014-1451-x

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