The influence of maternal and paternal education on birth outcomes: an analysis of the Ottawa and Kingston (OaK) birth cohort

Abstract

Background

Education is considered one of the most robust determinants of health. However, it is unclear whether maternal education and paternal education have differential impacts on perinatal health outcomes. We assess maternal and paternal education differences and their association with adverse birth outcomes in a large birth cohort from Ontario, Canada.

Methods

The OaK Birth Cohort recruited patients from Ontario, Canada, between October 2002 and April 2009. We recruited mothers were recruited between 12 and 20 weeks’ gestation and collected both mother and infant data. The final sample size of the cohort was 8,085 participants. We use logistic regression to model the probability of preterm birth (less than 34 and 37 weeks’ gestation), small-for-gestational-age (SGA), or stillbirth as a function of maternal and paternal educational attainment. We adjust for household-level income, maternal and paternal race and ethnicity, and compare the strength of the association between maternal and paternal education on outcomes using Wald tests.

Results

7,928 mother-father-offspring triads were available for the current analysis. 75% of mothers and fathers had college or university level education, and 8.7% of mothers experienced preterm delivery. Compared to mothers with college or university education, mothers with a high school education had an odds ratio of 1.37 (95% CI: 1.01–1.87) for SGA. Paternal education was not associated with infant outcomes. Comparing the odds ratios for maternal education and paternal education showed a stronger association than paternal education at the high school level for SGA birth (difference in odds ratio: 1.95, 95% CI: 1.13–3.36, p = .016) among women at least 25 years old.

Conclusion

Maternal education was associated with SGA, and this effect was more robust than paternal education, but both associations were weaker than previously reported.

Keywords:

• Parental education
• seriocomic status
• pregnancy outcome
• premature birth
• female
• income
• educational status

Author contributions

DJC conceptualized the study, contributed to the data analysis and wrote the revised version of the manuscript. AS designed the analytical strategy and contributed to data analysis and writing. MLL wrote the study protocol and contributed to an earlier draft of the manuscript. RRW, GS, SWW, MR, and MW designed and conducted the OaK Birth Cohort. All authors helped in data interpretation, manuscript revisions and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research did not receive any specific grant from funding agencies. The OaK Birth Cohort was supported by the Canadian Institutes of Health Research.