Paternity establishment

Paternity establishment for 90% of births to unwed mothers is a recent federal mandate designed to optimize parental rights and childhood benefits. Using a statewide database, this study examines the relationship between selected demographic and clinical variables and in-hospital paternity establishment. Vital statistics for the year 2000 were obtained pertaining to live birth deliveries in the state of Michigan. Data were developed by the Michigan Department of Community Health through linkage of state birth data files with a central paternity registry. Statistical comparisons were made of the frequency distributions of the study variables, using a normal approximation of binomial distribution. There were a total of 134,917 live births in Michigan during 2000. Of these, 46,057 (34.1%) were to unmarried women. The overall rate of in-hospital paternity establishment for these cases was 56% in 2000. A review of selected characteristics indicated a wide range of variability in the proportion of cases for which paternity is established. The following characteristics were significantly different (P<0.05) from the overall average rate (56%) of paternity establishment in 2000: African American, 37.3%; less than high school education, 48.3%; birth weight under 1500 g, 44.8%; birth weight 1500–2499 g, 48.4%; no prenatal care, 30.1%; third trimester care, 37.9%; second trimester care, 47.3%; abnormal newborn, 53.2%; gestational age ≤37 weeks, 50.7%; age less than 20, 52.8%. A greater than average rate of paternity establishment was noted with first trimester care (61.3%), high school or greater education (60.7%), and non–African-American race (71.3%). In conclusion, key demographic and clinical variables limiting the successful establishment of paternity are readily identifiable. In order to achieve the legislative mandate of 90% success, strategies must be developed to improve overall paternity establishment, with special emphasis on these target populations. In addition, these data suggest that racial and ethnic factors are important determinants of paternity establishment in the state of Michigan.