Introduction: The high neonatal mortality rate and low birth-weight (LBW) births are a serious public health concern of developing countries including Pakistan. These adverse birth outcomes have significant individual, familial and developmental consequences. Traditionally, research has focused on maternal factors for investigating the determinants of adverse birth outcomes. Nevertheless, of late, many scientists argue that various paternal factors are also associated with high risk of congenital anomalies, fetal death, miscarriage, preterm births, and LBW babies. The aim of this study was to discern paternal factors associated with the adverse birth outcomes particularly neonatal mortality and LBW births, independent of maternal and other socio-demographic factors.

Methods: Data from Pakistan Demographic and Health Survey (DHS) 2006-07 were used. DHS collected information from a nationally representative sample of 10,023 ever married women of reproductive age (15-49 years). The information about births was derived from the maternal survey. Our analysis was restricted to women who gave at least one birth in the last five years prior to the survey. For adverse birth outcomes, we used two dependent variables, i.e. neonatal deaths and LBW. Multiple logistic regression was applied to estimate the independent effect of the paternal factors on adverse birth outcomes. In the analysis we adjusted the paternal factors (father’s age, education and occupation) for maternal factors (mother’s age, education, use of antenatal care, place of delivery) as well as other factors such as consanguinity and wealth index.

Results: Among the selected sample of women (n=5724) 4% reported neonatal deaths and 34% had LBW babies. We found that fathers involved in manual occupation were more likely to have neonatal deaths than fathers involved in managerial/professional jobs (Adjusted Odds Ratio [AOR] 2.00, 95% Confidence Interval [CI] 1.03-3.85). Similarly, father’s unemployment status was associated with LBW babies (AOR 1.52, 95%CI 1.06-2.16). In addition to paternal occupation, consanguinity was a major risk factor which could influence neonatal deaths (AOR 1.48, 95%CI 1.07-2.05) and LBW (AOR 1.14, 95%CI 1.02-1.30).

Conclusions: This study highlighted the association of paternal factors, particularly father’s occupation, with adverse birth outcomes after adjusting for significant confounders. As the number of available paternal factors in the study was limited, further studies are warranted to discern other paternal risk factors related to adverse birth outcomes.