Fatherhood and interconception care: An analysis of paternity acknowledgement and interpregnancy intervals in the US

Existing research suggests that adequate spacing between pregnancies may reduce perinatal morbidities. The research on interpregnancy intervals (IPIs) overlooks the role of paternal influences in interconception care. Thus, the present study aims to explore associations between paternity acknowledgment (PA) and IPI. 2020 US birth certificate data were used. Birthing people aged 18-44 whose singleton birth was not their first pregnancy were included. The exposure was categorized as married, unmarried with PA, and unmarried without PA. IPI was defined as short (≤ 18 months), intermediate (19-23 months), and long (≥24 months). Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). After adjustment, missing PA was associated with short (AOR = 1.16, 95% CI= 1.14, 1.18) and long IPIs (AOR = 1.71, 95% CI= 1.67, 1.74) compared to married individuals. Similarly, those unmarried individuals with PA also had greater odds of short (AOR= 1.14, 95% CI= 1.13, 1.16) and long (AOR= 1.80, 95% CI= 1.77, 1.82) intervals compared to married people. The findings suggest that paternal influences may play a significant role in family planning. However, as PA was an inferential variable and does not holistically capture the benefits of paternal involvement, studies with a more robust measure of paternity are needed.