(221) Linking Male Parents to Pregnancies and Infants in a Health Insurance Claims Database

Publication Number: 552

Background: The identification of male parents in claims data would allow for assessment of paternal and familial environmental exposures, and evaluation of effects of these exposures on risk of pregnancy and infant outcomes (e.g., miscarriage, congenital malformation). Paternal exposures may also represent negative control exposures in pregnancy and infant outcome studies.

Objectives: To assess the feasibility of linking male parents to pregnancies and infants within a claims database.

Methods: Using Optum’s Dynamic Assessment of Pregnancies and Infants (DAPI), an existing mother-infant linked claims database, pregnancies among women aged 18-55 years and their linked infants were identified. Pregnancies were linked to potential male parents, defined as individuals with the same family member identifier at any time between the start of pregnancy (estimated date of last menstrual period [LMP]) and the pregnancy end date, including an additional timeframe of 30 days before and after. Linked male parents were required to be 18-55 years on the LMP date.
To reduce the potential for linkage to a non-parent male family member (e.g. father or brother of the pregnant female), we restricted to the subset of pregnancies linked to one male only, pregnancies with mother’s age greater than 26, and pregnancies where the mother’s age was within 10 years of the linked male’s age. We chose a minimum maternal age of 26 to account for the potential for younger mothers to be included under their parent’s health plan.

Results: A total of 1,192,044 pregnancies occurring between October 2015 and August 2021 were identified as the source within which to link to potential male parents. The mean maternal age was 31 years. There were 725,048 pregnancies (61%) with linkage to one or more potential male parents, and 682,746 pregnancies (57%) with linkage to a single potential male parent. Of the pregnancies with one linked male, 403,603 pregnancies (59%) linked to an infant. Further restricting to pregnancies with mother’s age greater than 26 and within 10 years of the linked male’s age, 533,557 pregnancies (45%) were linked to a male.
Among pregnancies with one linked male, the average age for mothers was 31 years and linked males was 35 years. Compared to pregnancies linked to one male only, mothers of pregnancies with more than one linked male tended to be younger on average with a greater age difference between the mother and linked males.

Conclusions: The linkage of pregnancies and infants to male parents in a claims database is feasible, using information on sex, age, pregnancy start and end dates, and the family member identifier. Further characterization of the linked males and of pregnancies with and without a linked male would be needed to strengthen inferences.