Forgotten fathers An exploratory study of mothers' report of drug and alcohol problems among fathers of urban newborns
Deborah A. Frank, , a, Jeffrey Brownb, Sarah Johnsonc and Howard Cabrald a Department of Pediatrics, Boston University School of Medicine, Boston, MA, USAb American Pediatric Society and Society for Pediatric Research Student Research Program, Brown University School of Medicine, Providence, RI, USAc American Pediatric Society and Society for Pediatric Research Student Research Program, Cornell Medical College, NY, USAd Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, MA, USA Received 23 August 2001; revised 15 November 2001; accepted 19 December 2001 Available online 3 February 2002.
Abstract
Objectives: To investigate the relationship between fathers' substance use and maternal and paternal background characteristics, infant outcome measures, and fathers' frequency of caregiving at 6 months postpartum in a cohort of cocaine-exposed and unexposed infants. Methods: Secondary analysis was completed on data collected through interviews and medical records obtained from 252 mothers participating in an ongoing longitudinal study of cocaine-exposed and unexposed mothers and infants. Results: By maternal report, 22% of the mothers reported that the father of the baby had a history of a drug and/or alcohol problem. Mothers who were classified as heavier cocaine users were 1.6 times more likely than lighter cocaine users and 2.6 times more likely than nonusers to report that the father of the baby had a history of a drug and/or alcohol problem. There was a significant relationship between the father's reported history of a drug and/or alcohol problem and the mother's history of mental and physical abuse during pregnancy; P=.03, P=.001, respectively). Fathers with a history of a drug and/or alcohol problem were more likely to have been in jail (P=.001) and to be unemployed at the time of delivery (P=.04) than fathers without a history of a drug and/or alcohol problem. On bivariate analysis, newborns of fathers with a history by mother's report of a drug or alcohol problem had significantly lower mean birthweights (3003 vs. 3213 g, P=.005) and lengths (47.5 vs. 48.6 cm, P=.01) than newborns of fathers with no such history. However after control for mothers' prenatal use of cocaine, marijuana, cigarettes, and alcohol and for infant gender and gestational age, the differences were not statistically significant (P=.15 for both measurements). Head circumference did not differ significantly between groups in either bivariate or multivariate analyses. Fathers with a reported history of drug and/or alcohol problems were more likely to care for the baby at least once a week than fathers without such a history of a drug and/or alcohol problem at 6 months postpartum. Conclusions: Childhood cognitive and behavioral outcomes currently attributed to maternal substance abuse may also reflect the genetic, teratogenic, and social influence of fathers. Within an urban, at-risk population, it is important to inquire about the father's participation in the day-to-day life of the infant and to address the father's as well as the mother's possible need for substance abuse treatment and support in parenting.