USF Public Health Faculty Invited to Capitol Hill

They speak out on prematurity and paternal involvement in birth outcomes

Two USF College of Public Health faculty members were in the national public policy spotlight in May -- speaking out on the consequences of prematurity, poor pregnancy outcomes and health disparities.
Charles Mahan, MD, professor emeritus and former dean of public health, testified May 12 in Washington, DC, before the House of Representatives Subcommittee on Health at a hearing focused on what happens when babies are born too early. Dr. Mahan, founder of the Lawton and Rhea Chiles Center for Healthy Mothers and Babies at USF, was invited to participate in the hearing by U.S. Congresswoman Kathy Castor.
Amina Alio, PhD, research assistant professor in the Department of Community and Family Health, spoke May 20 at a Capitol Hill briefing on the role of expectant fathers in birth outcomes. Dr. Alio was invited to participate in the briefing organized by Congressman Danny Davis. The briefing coincided with a report released by the Joint Center for Political and Economic Studies’ Commission on Paternal Involvement in Pregnancy.

Charles Mahan, MD, spoke to the House of Representatives Subcommittee on Health about how elective C-sections are compounding the problem of premature births in Florida, particularly among black women.
Florida’s rate of babies born prematurely is higher than the national average, a troubling trend because studies show correlations between preterm births and low-birth-weight babies and neurodevelopental disorders. Roughly 12.3 percent of all U.S. births are preterm – delivered before the 37th week of pregnancy, according to a new report released the National Center for Health Statistics. Nearly 14 percent of babies born in Florida are premature.
The earlier a baby is born before full-term (40 weeks) the greater the likelihood of complications such as respiratory distress from premature lungs.
Now lawmakers are working with experts, including those at USF, to find out why so many babies are born early so that public health interventions can be developed to reduce prematurity. In particular, they are trying to understand why preterm birth disproportionately affects black infants.
In Hillsborough County, the rate of infant mortality is four times higher for black women than non-Hispanic white women. Chronic stress is a factor contributing to higher rates of prematurity and infant mortality in black women, Dr. Mahan said, and rising rates of medically unnecessary C-sections may compound the problem. Black women in the United States have had the highest cesarean rates of any group for more than 10 years.
"In Florida, we are finding that elective induction of labor and C-sections in normal women are producing an excessive number of pre-term babies,” Dr. Mahan said. "Because their brains are not as well developed as full-term babies, these premature babies often do not do as well from a health and development standpoint, which can lead to educational problems when they get to school."
The USF Chiles Center is helping coordinate a statewide task force of physicians, nurse midwives and public health professionals who can address this problem.
Public health experts at the Joint Commission briefing called for more research and policy changes to boost the involvement of fathers-to-be in helping to ensure healthy pregnancies and births.

Amina Alio, PhD, spoke about fathers' involvement in pregnancy at a panel sponsored by the Joint Center for Political and Economic Studies.
"First, there is a lack of research on this issue, and, secondly, the emphasis on the maternal aspect of reproductive health has caused us to ignore the role of the father beyond conception,” Dr. Alio said in her remarks at the Capitol Hill briefing. "Recognizing the important contribution of men to the physical health and well-being of the family is the necessary first step to addressing problems of health disparities and infant mortality that have plagued out nation for decades.”
Dr. Alio – working with USF’s Hamisu Salihu, MD, PhD, and Phillip Marty, PhD -- has conducted studies on whether a father’s involvement during pregnancy makes a difference in infant survival and health. Her research grew out the frustration she heard from community members about the absence of men in programs and activities focused on improving the health of babies.
The USF researchers examined the records of all births in Florida from 1998 to 2005 – more than 1.39 million births. Father involvement was defined by the inclusion of the father’s information on the infant’s birth certificate. Even after adjusting for sociodemographic differences, they found infants with absent fathers were significantly more likely to be born with lower birth weights, to be preterm and small for gestational age. The risks of negative pregnancy outcomes were even higher for black infants with absent fathers.
Infants born to black women whose babies’ fathers were absent during their pregnancies had a seven times greater risk of infant mortality than infants born to Hispanic and white women in the same situation, the USF study found.
Dr. Alio suggested paternal support may decrease the mother’s emotional stress, which has been linked to poor pregnancy outcomes, or promote healthy prenatal behavior. For instance, some studies have indicated that pregnant women are more likely to smoke during pregnancy and get inadequate prenatal care if their partners are absent. Barriers to expectant fathers’ involvement in the lives of their pregnant partners, including issues like unemployment, relationship status, and participation in prenatal visits, must be examined to increase the role of men during pregnancy, she said.
Improving the involvement of expectant fathers holds promise for reducing costly medical treatments for the complications of premature births as well as reducing infant mortality rates, particularly in black communities, she said.
"When fathers are involved, children thrive in school and in their development,” Dr. Alio said, "so it should be no surprise that when fathers are present in the lives of pregnant mothers, babies fare much better.”
- Story by Anne DeLotto Baier, USF Health Communications