(276) Linkage of Pregnancies and Infants to Potential Male Parents in a Health Insurance Claims Database

Background: There is a growing body of evidence focused on the safety of paternal exposures on pregnancy and infant outcomes. The linkage of pregnancies and infants to male parents in claims data would allow for ascertainment of paternal or familial drug exposures and evaluation of their effects on pregnancy and infant outcomes.

Objectives: To identify potential male parents of pregnancies and infants within a claims database and describe the pregnancies with and without a linked male.

Methods: Pregnancies among females of age 18-55 years and their linked infants were identified between January 2018 and August 2023 using the Optum Dynamic Assessment of Pregnancies and Infants (DAPI). A variable indicating the relationship of the individual to the insurance plan was used to reduce the likelihood of linkage to a male family member who is not a parent of the pregnancy. For each pregnancy, potential male parents were defined as individuals with the following criteria: (1) the same family member identifier as the pregnant female at any time during the pregnancy period, which spanned from the estimated date of last menstrual period (LMP) to the end of pregnancy, including 30 days before and after this period; (2) male sex; (3) age of 18-65 years at the start of the pregnancy; and (4) a relationship to the health insurance plan of either Spouse or Employee. Pregnancy-male linkages in which either the male or the pregnant female had a relationship to the health insurance plan of Child were excluded. Pregnancy-male linkages with an unknown relationship to the insurance plan were included if there was only 1 linked male and the male’s age was within 10 years of the pregnant female’s age.

Results: Of the 772,276 pregnancies identified, 394,632 (51%) were linked to at least 1 potential male parent. Of the linked pregnancies, 393,160 (>99%) were linked to only 1 male and 220,708 (56%) had a linked infant. Among pregnancies linked to a male, the pregnant female’s relationship to the health insurance plan was Spouse for 268,850 pregnancies (68%), Employee for 108,998 pregnancies (28%), and unknown for 16,784 pregnancies (4%). In 312,575 (79%) of the pregnancy-male linkages, the linked male had at least 6 months of continuous enrollment prior to the start of pregnancy. The pregnant females linked to a potential male parent were older on average compared to the pregnant females not linked to a male (32.1 versus 29.3 years).

Conclusions: Pregnancies and infants can be linked to potential male parents using variables available in administrative claims, including age, sex, the pregnancy period, family member identifier, and relationship to the health insurance plan. This linkage may be useful in studies where assessment of paternal or familial exposure is needed.