Abstract / Summary
Abstract Background Preterm birth remains a leading cause of infant mortality, with rates disproportionately high among Black women in the United States. While maternal risk factors are well-studied, paternal influences, particularly in Black families, remain underexplored. This study examined associations between paternal factors and preterm birth in a predominantly Black sample. Methods We analyzed data from 221 fathers in the Fathers Matter study, embedded within the Biosocial Impact on Black Births (BIBB) cohort study. Paternal sociodemographic, health, behavioral and psychosocial data were collected prenatally. Preterm birth, defined as gestational age < 37 weeks was ascertained from medical records of participants in the BIBB study. Logistic regression was used for analysis. Results Unadjusted logistic regression models showed significant associations between lower annual household income (OR = 2.35, 95% CI: 1.71–4.71), light cigarette smoking (OR = 3.17, 95% CI: 1.44–6.95), preterm birth. Conversely, paternal age was associated with decreased odds with the highest reduction among fathers 30–34 years (OR = 0.12, 95% CI: 0.03–0.43) compared to ages 18–24. The effects of annual household income and cigarette smoking were attenuated when adjusted for maternal perceived stress and depressive symptoms, while the protective effect of age persisted. These findings highlight the interdependency of paternal and maternal factors in shaping birth outcomes. Conclusion This study advances the field by centering Black fathers, moving beyond deficit-focused frameworks and highlighting the need for father-inclusive approaches that consider diverse contexts in efforts to reduce preterm birth and promote optimal maternal and infant health.