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Van Vliet MM, Schoenmakers S, Haug B, Willemsen S, Steegers-Theunissen RPM. Paternal age and first trimester placental size and growth: The Rotterdam Periconceptional Cohort. Placenta 2024; 150:1-7. [PMID: 38537411 DOI: 10.1016/j.placenta.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/06/2024] [Accepted: 03/15/2024] [Indexed: 05/04/2024]
Abstract
INTRODUCTION Despite a noticeable trend of delayed fatherhood, less is known about the impact of paternal age on the paternally programmed placenta. We hypothesize that paternal aging affects seminal quality and as such induces ageing-related epigenetic alterations that influence placental growth. Our main aim is to investigate associations between paternal age and first trimester (vascular) placental growth trajectories. METHODS Pregnant women were enrolled before 10 weeks of gestation in the Rotterdam Periconceptional Cohort (Predict study). Placental volumes (PV) and utero-placental vascular volumes (uPVV) were measured at 7, 9, and 11 weeks gestation. Associations between paternal age and PV and uPVV were investigated using linear mixed models and the maximum likelihood ratio test to test non-linear relationships. We adjusted for gestational age, fetal sex, parental smoking and maternal age, BMI, education and parity, and stratified for conception mode. RESULTS From 808 pregnancies we obtained 1313 PV and from 183 pregnancies 345 uPVV measurements. We show no associations between paternal age and PV (p = 0.934) and uPVV (p = 0.489) in our total population or in pregnancies conceived naturally (PV p = 0.166; uPVV p = 0.446) and after IVF/ICSI (PV p = 0.909; uPVV p = 0.749). For example, PV was 0.9% smaller (95% CI -5.7%-7.1%) in fathers aged 40 compared to 30 years old at 9 weeks gestation in the total study population. DISCUSSION We are not demonstrating a significant impact of paternal age on first trimester placental growth in a tertiary care population. Given the trend of increasing paternal age, our study should be repeated in the general population.
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Affiliation(s)
- M M Van Vliet
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Developmental Biology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - S Schoenmakers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - B Haug
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - S Willemsen
- Department Biostatistics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
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Katlaps I, Ghafari-Saravi A, Mandelbaum A, Packer CH, Doshi U, Garg B, Caughey AB, Valent AM. Adverse Perinatal and Neonatal Outcomes among Adolescent Pregnancies in the United States. Am J Perinatol 2024; 41:e2495-e2504. [PMID: 37399846 DOI: 10.1055/a-2121-7698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
OBJECTIVE Despite a downward trend in recent years, adolescent pregnancies in the United States remain higher than any other western country. Adolescent pregnancies have been inconsistently associated with adverse perinatal outcomes. The objective of this study is to investigate the association between adolescent pregnancies and adverse perinatal and neonatal outcomes in the United States. STUDY DESIGN This is a retrospective cohort study of singleton births in the United States from 2014 to 2020 using national vital statistics data. Perinatal outcomes included gestational diabetes, gestational hypertension, preterm delivery <37 weeks (preterm birth [PTB]), cesarean delivery (CD), chorioamnionitis, small for gestational age (SGA), large for gestational age (LGA), and neonatal composite outcome. Chi-square tests were used to compare outcomes among adolescent (13-19 years) versus adult (20-29 years) pregnancies. Multivariable logistic regression models were used to examine association of adolescent pregnancies with perinatal outcomes. For each outcome, we utilized three models: unadjusted logistic regression, adjusted for demographics, and adjusted for demographics and medical comorbidities. Similar analyses were used to compare younger (13-17 years) and older (18-19 years) adolescent pregnancies to adults. RESULTS In a cohort of 14,014,078 pregnancies, we found that adolescents were at an increased risk of PTB (adjusted odds ratio [aOR]: 1.12, 99% confidence interval (CI): 1.12-1.13) and SGA (aOR: 1.02, 99% CI: 1.01-1.03) compared with adult pregnancies. We also found that multiparous adolescents with a prior history of CD were at an increased risk of CD, compared with adults. For all other outcomes, adult pregnancies were at higher risk for adverse outcomes in the adjusted models. When comparing birth outcomes among adolescents, we found that older adolescents are at an increased risk of PTB, whereas younger adolescents are at an increased risk of both PTB and SGA. CONCLUSION After adjusting for confounders, our study demonstrates adolescents have an increased risk of PTB and SGA, compared with adults. KEY POINTS · Adolescents as a whole subgroup have an increased risk of PTB and SGA compared with adults.. · Younger adolescents have a risk of PTB and SGA, whereas older adolescents have a risk of PTB only.. · Adverse birth outcomes in adults are gestational diabetes, chorioamnionitis, LGA, and worse neonatal composite score..
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Affiliation(s)
- Isabel Katlaps
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Afsoon Ghafari-Saravi
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Ava Mandelbaum
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Claire H Packer
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Uma Doshi
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Bharti Garg
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Aaron B Caughey
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Amy M Valent
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
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Yu VT, Ramsay JM, Horns JJ, Mumford SL, Bruno AM, Hotaling J. The association between parental age differences and perinatal outcomes. Hum Reprod 2024; 39:425-435. [PMID: 37968231 PMCID: PMC10833074 DOI: 10.1093/humrep/dead236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/23/2023] [Indexed: 11/17/2023] Open
Abstract
STUDY QUESTION Are there significant associations existing between parental age differences and adverse perinatal outcomes? SUMMARY ANSWER Large differences in parental age are associated with adverse perinatal outcomes, particularly with older mothers paired with younger fathers. WHAT IS KNOWN ALREADY The association between advanced maternal age and perinatal outcomes is well-documented with women over 35 years showing an increased risk of several adverse outcomes. Other studies have identified potential associations between advanced paternal age and adverse perinatal outcomes. STUDY DESIGN, SIZE, DURATION A historical (retrospective) cohort analysis was performed utilizing a multivariable logistic regression model to evaluate the association between varying differences in parental age and adverse perinatal outcomes while controlling for demographic and health-related covariates. Data were compiled from the National Vital Statistics System for 20 613 704 births between 2012 and 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS Parental age differences, categorized into eleven 4-year intervals, were stratified by seven maternal age categories and evaluated for their associations with adverse perinatal outcomes. Main outcome measures included low birth weight, very low birth weight, preterm birth, very preterm birth, small size for gestational age, low 5-min appearance, pulse, grimace, activity, and respiration score, congenital defects, and chromosomal anomalies. MAIN RESULTS AND THE ROLE OF CHANCE Increased parental age differences, in either direction, were associated with significant risks for all adverse outcomes, aside from congenital defects, even when controlling for maternal age. Restricting maternal age to the reference range of 25-29 years, infants born to fathers aged 9-12 years younger (n = 3773) had 27% (odds ratio (OR) 1.27, 95% CI, 1.17-1.37) higher odds of having any adverse perinatal outcome. Infants born to fathers aged >16 years older (n = 98 555) had 14% (OR 1.14, 95% CI, 1.12-1.16) higher odds of having any adverse perinatal outcome. LIMITATIONS, REASONS FOR CAUTION Data extracted from US birth certificates may be compromised by errors in reporting or documentation. Information regarding the mother's socioeconomic status was estimated using proxy variables and may be susceptible to uncontrolled factors. Use of a pre-compiled dataset may potentially exclude additional maternal comorbidities that could impact perinatal outcomes. WIDER IMPLICATIONS OF FINDINGS Older mothers paired with younger fathers demonstrated the highest risk, even when maternal age was below the threshold of 35 years. For the clinical setting, parental age differences should be considered alongside maternal and paternal age when assessing risks of adverse perinatal outcomes for potential parents. This is particularly relevant for older women with younger male partners as this may exacerbate the impact of advanced maternal age. STUDY FUNDING/COMPETING INTEREST(S) This research was funded by the NIH Research Fellowship T35 Training Grant. There are no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Victor T Yu
- Department of Surgery, University of Nevada Reno School of Medicine, Reno, NV, USA
| | - Joemy M Ramsay
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Joshua J Horns
- Division of Vascular Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sunni L Mumford
- Division of Epidemiology, Department of Biostatistics, Epidemiology & Informatics and Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ann M Bruno
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Jim Hotaling
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
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Navarro-Gomezlechon A, Gil Juliá M, Pacheco-Rendón RM, Hervás I, Mossetti L, Rivera-Egea R, Garrido N. Obstetrical and Perinatal Outcomes Are Not Associated with Advanced Paternal Age in IVF or ICSI Pregnancies with Autologous Oocytes. BIOLOGY 2023; 12:1256. [PMID: 37759655 PMCID: PMC10525525 DOI: 10.3390/biology12091256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/20/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND In recent years, there has been an evident delay in childbearing and concerns have been raised about whether this increase in age affects reproductive outcomes. This study aimed to evaluate the effect of paternal age on obstetrical and perinatal outcomes in couples undergoing in vitro fertilization or intracytoplasmic sperm injection using autologous sperm and oocytes. METHODS This retrospective study evaluated obstetrical and perinatal outcomes from 14,125 couples that were arbitrarily divided into three groups according to paternal age at conception: ≤30 (n = 1164), 31-40 (n = 11,668) and >40 (n = 1293). Statistics consisted of a descriptive analysis followed by univariate and multivariate models, using the youngest age group as a reference. RESULTS The study showed significantly longer pregnancies for the fathers aged 31-40 compared to ≤30 years. However, there were no significant differences for the type of delivery, gestational diabetes, anaemia, hypertension, delivery threat, premature rupture of membranes, preterm birth, very preterm birth, and the neonate's sex, weight, low birth weight, very low birth weight, length, cranial perimeter, Apgar score and neonatal intensive care unit admission. CONCLUSION Despite our promising results for older fathers, as paternal age was not associated with clinically relevant obstetrical and perinatal outcomes, future well-designed studies are necessary as it has been associated with other important disorders.
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Affiliation(s)
- Ana Navarro-Gomezlechon
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain; (M.G.J.); (R.M.P.-R.); (N.G.)
| | - María Gil Juliá
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain; (M.G.J.); (R.M.P.-R.); (N.G.)
| | - Rosa María Pacheco-Rendón
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain; (M.G.J.); (R.M.P.-R.); (N.G.)
| | - Irene Hervás
- IVIRMA Global Research Alliance, IVIRMA Roma, Via Federico Calabresi, 11, 00169 Roma, Italy; (I.H.); (L.M.)
| | - Laura Mossetti
- IVIRMA Global Research Alliance, IVIRMA Roma, Via Federico Calabresi, 11, 00169 Roma, Italy; (I.H.); (L.M.)
| | - Rocío Rivera-Egea
- IVIRMA Global Research Alliance, Andrology Laboratory and Sperm Bank, IVIRMA Valencia, Plaza de la Policia Local 3, 46015 Valencia, Spain;
| | - Nicolás Garrido
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain; (M.G.J.); (R.M.P.-R.); (N.G.)
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Zaks N, Batuure A, Lin E, Rommel AS, Reichenberg A, Grice D, Bergink V, Fox NS, Mahjani B, Janecka M. Association Between Mental Health and Reproductive System Disorders in Women: A Systematic Review and Meta-analysis. JAMA Netw Open 2023; 6:e238685. [PMID: 37071426 PMCID: PMC10114079 DOI: 10.1001/jamanetworkopen.2023.8685] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/04/2023] [Indexed: 04/19/2023] Open
Abstract
Importance Reproductive system and mental health disorders are commonly comorbid in women. Although the causes of this overlap remain elusive, evidence suggests potential shared environmental and genetic factors associated with risk. Objective To investigate the comorbidity between psychiatric and reproductive system disorders, both as broad diagnostic categories and among specific pairs of diagnoses. Data Source PubMed. Study Selection Observational studies published between January 1980 and December 2019 assessing prevalence of psychiatric disorders in women with reproductive system disorders and prevalence of reproductive system disorders in women with psychiatric disorders were included. The study did not include psychiatric and reproductive disorders triggered by life events (eg, trauma, infection, surgery) to address potential confounding. Data Extraction and Synthesis A search yielded 1197 records, of which 50 met the inclusion criteria for the qualitative and 31 for the quantitative synthesis in our study. A random-effects model was used for data synthesis and Egger test and I2 to assess study bias and heterogeneity. Data were analyzed from January to December 2022. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Main Outcomes and Measures Psychiatric and reproductive system disorders. Results A total of 1197 records were identified, of which 50 met the inclusion criteria for qualitative and 31 for quantitative synthesis. Diagnosis of a reproductive system disorder was associated with a 2- to 3-fold increased odds of having a psychiatric disorder (lower bound odds ratio [OR], 2.00; 95% CI, 1.41-2.83; upper bound OR; 2.88; 95% CI, 2.21-3.76). The analysis focused on specific diagnoses described in the literature and found that polycystic ovary syndrome was associated with increased odds of depression (population-based studies OR, 1.71; 95% CI, 1.19-2.45; clinical studies OR, 2.58; 95% CI, 1.57-4.23) and anxiety (population-based studies OR, 1.69; 95% CI, 1.36-2.10; clinical studies OR, 2.85; 95% CI, 1.98-4.09). Chronic pelvic pain was also associated with both depression (OR, 3.91; 95% CI, 1.81-8.46) and anxiety (OR, 2.33; 95% CI, 1.33-4.08). Few studies investigated risk of other reproductive system disorders in women with psychiatric disorders, or reverse associations (risk of reproductive system disorder among women with a psychiatric diagnosis). Conclusions and Relevance In this systematic review and meta-analysis, a high rate of reported co-occurrence between psychiatric and reproductive disorders overall was observed. However, data for many disorder pairs were limited. The available literature focused overwhelmingly on affective disorders in polycystic ovary syndrome, overlooking a substantial portion of disease overlap. As such, the associations between the majority of mental health outcomes and conditions of the female reproductive system are largely unknown.
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Affiliation(s)
- Nina Zaks
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anita Batuure
- Rutgers University, Graduate School of Applied and Professional Psychology, Piscataway, New Jersey
| | - Emma Lin
- Cornell University, Undergraduate Studies, Ithaca, New York
| | - Anna-Sophie Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dorothy Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Tics, OCD and Related Disorders, Icahn School of Medicine at Mount Sinai, New York, New York
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Psychiatry, Erasmus Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Nathan S. Fox
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Behrang Mahjani
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Tics, OCD and Related Disorders, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Magdalena Janecka
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
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Navarro-Gomezlechon A, Gil Juliá M, Hervás I, Mossetti L, Rivera-Egea R, Garrido N. Advanced Paternal Age Does Not Affect Medically-Relevant Obstetrical and Perinatal Outcomes following IVF or ICSI in Humans with Donated Oocytes. J Clin Med 2023; 12:jcm12031014. [PMID: 36769665 PMCID: PMC9918020 DOI: 10.3390/jcm12031014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Concomitant with delays in childbearing, concerns have been raised of whether advanced paternal age is associated with adverse reproductive outcomes, but the evidence is controversial in part due to the uncertain threshold in which to consider advanced paternal age and confounding maternal factors. This retrospective study aimed to evaluate the effect of paternal age on reproductive outcomes related to the pregnancy and perinatal health of the offspring. METHODS We retrospectively evaluated 16,268 cases of patients who underwent IVF or ICSI (using autologous sperm and donated oocytes, between January 2008 and March 2020, at Spanish IVIRMA clinics. Patients were divided based on paternal age at conception [≤30 (n = 204), 31-40 (n = 5752), and >40 years (n = 10,312)], and the differences in obstetrical and perinatal outcomes were analyzed by descriptive analysis, followed by univariate and multivariate analysis. RESULTS Fathers 31-40 and >40 years old were associated with lower odds of caesarean delivery [AOR 0.63 (95% CI, 0.44-0.90; p = 0.012) and AOR 0.61 (95% CI, 0.41-0.91; p = 0.017), respectively] and longer pregnancies [ARC 5.09 (95% CI, 2.39-7.79; p < 0.001) and ARC 4.54 (95% CI, 1.51-7.58; p = 0.003), respectively] with respect to fathers ≤30 years old. Furthermore, fathers aged 31-40 years old had lower odds of having a female infant (AOR, 0.70; 95% CI, 0.49-0.99; p = 0.045) than those ≤30. The rest of obstetrical and perinatal outcomes, which we deemed more medically-relevant as they were considered serious for health, were comparable between groups with our adjusted model. CONCLUSIONS Despite this hopeful message to fathers of advanced paternal age, future studies should consider the short- and long-term outcomes of the offspring and try to better elucidate the associations of advanced paternal age with reproductive outcomes and the molecular mechanisms underlying the observed associations.
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Affiliation(s)
- Ana Navarro-Gomezlechon
- IVI Foundation—Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain
- Correspondence:
| | - María Gil Juliá
- IVI Foundation—Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain
| | - Irene Hervás
- IVI Foundation—Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain
- IVF Laboratory, IVIRMA Roma, Via Federico Calabresi, 11, 00169 Rome, Italy
| | - Laura Mossetti
- IVI Foundation—Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain
- IVF Laboratory, IVIRMA Roma, Via Federico Calabresi, 11, 00169 Rome, Italy
| | - Rocío Rivera-Egea
- Andrology Laboratory and Sperm Bank, IVIRMA Valencia, Plaza de la Policia Local 3, 46015 Valencia, Spain
| | - Nicolás Garrido
- IVI Foundation—Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain
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Wood KA, Goriely A. The impact of paternal age on new mutations and disease in the next generation. Fertil Steril 2022; 118:1001-1012. [PMID: 36351856 PMCID: PMC10909733 DOI: 10.1016/j.fertnstert.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
Advanced paternal age is associated with an increased risk of fathering children with genetic disorders and other adverse reproductive consequences. However, the mechanisms underlying this phenomenon remain largely unexplored. In this review, we focus on the impact of paternal age on de novo mutations that are an important contributor to genetic disease and can be studied both indirectly through large-scale sequencing studies and directly in the tissue in which they predominantly arise-the aging testis. We discuss the recent data that have helped establish the origins and frequency of de novo mutations, and highlight experimental evidence about the close link between new mutations, parental age, and genetic disease. We then focus on a small group of rare genetic conditions, the so-called "paternal age effect" disorders that show a strong association between paternal age and disease prevalence, and discuss the underlying mechanism ("selfish selection") and implications of this process in more detail. More broadly, understanding the causes and consequences of paternal age on genetic risk has important implications both for individual couples and for public health advice given that the average age of fatherhood is steadily increasing in many developed nations.
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Affiliation(s)
- Katherine A Wood
- Radcliffe Department of Medicine, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Anne Goriely
- Radcliffe Department of Medicine, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, Oxford, United Kingdom.
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Aradhya S, Tegunimataka A, Kravdal Ø, Martikainen P, Myrskylä M, Barclay K, Goisis A. Maternal age and the risk of low birthweight and pre-term delivery: a pan-Nordic comparison. Int J Epidemiol 2022; 52:156-164. [PMID: 36350574 PMCID: PMC9908063 DOI: 10.1093/ije/dyac211] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 10/20/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Advanced maternal age at birth is considered a risk factor for adverse birth outcomes. A recent study applying a sibling design has shown, however, that the association might be confounded by unobserved maternal characteristics. METHODS Using total population register data on all live singleton births during the period 1999-2012 in Denmark (N = 580 133; 90% population coverage), Norway (N = 540 890) and Sweden (N = 941 403) and from 2001-2014 in Finland (N = 568 026), we test whether advanced maternal age at birth independently increases the risk of low birthweight (LBW) (<2500 g) and pre-term birth (<37 weeks gestation). We estimated within-family models to reduce confounding by unobserved maternal characteristics shared by siblings using three model specifications: Model 0 examines the bivariate association; Model 1 adjusts for parity and sex; Model 2 for parity, sex and birth year. RESULTS The main results (Model 1) show an increased risk in LBW and pre-term delivery with increasing maternal ages. For example, compared with maternal ages of 26-27 years, maternal ages of 38-39 years display a 2.2, 0.9, 2.1 and 2.4 percentage point increase in the risk of LBW in Denmark, Finland, Norway and Sweden, respectively. The same patterns hold for pre-term delivery. CONCLUSIONS Advanced maternal age is independently associated with higher risk of poor perinatal health outcomes even after adjusting for all observed and unobserved factors shared between siblings.
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Affiliation(s)
- Siddartha Aradhya
- Demography Unit and Department of Sociology, Stockholm University, Stockholm, Sweden,Centre for Economic Demography, Lund University, Lund, Sweden
| | | | - Øystein Kravdal
- Department of Economics, University of Oslo, Oslo, Norway,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Pekka Martikainen
- Max Planck Institute for Demographic Research, Rostock, Germany,Population Research Unit and Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Rostock, Germany,Population Research Unit and Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Kieron Barclay
- Corresponding author. Department of Sociology, Stockholm University, 106 91 Stockholm, Sweden. E-mail:
| | - Alice Goisis
- Social Research Institute, University College London, London, UK
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9
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Zhang C, Yan L, Qiao J. Effect of advanced parental age on pregnancy outcome and offspring health. J Assist Reprod Genet 2022; 39:1969-1986. [PMID: 35925538 PMCID: PMC9474958 DOI: 10.1007/s10815-022-02533-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/24/2021] [Indexed: 10/16/2022] Open
Abstract
PURPOSE Fertility at advanced age has become increasingly common, but the aging of parents may adversely affect the maturation of gametes and the development of embryos, and therefore the effects of aging are likely to be transmitted to the next generation. This article reviewed the studies in this field in recent years. METHODS We searched the relevant literature in recent years with the keywords of "advanced maternal/paternal age" combined with "adverse pregnancy outcome" or "birth defect" in the PubMed database and classified the effects of parental advanced age on pregnancy outcomes and birth defects. Related studies on the effect of advanced age on birth defects were classified as chromosomal abnormalities, neurological and psychiatric disorders, and other systemic diseases. The effect of assisted reproduction technology (ART) on fertility in advanced age was also discussed. RESULTS Differences in the definition of the range of advanced age and other confounding factors among studies were excluded, most studies believed that advanced parental age would affect pregnancy outcomes and birth defects in offspring. CONCLUSION To some extent, advanced parental age caused adverse pregnancy outcomes and birth defects. The occurrence of these results was related to the molecular genetic changes caused by aging, such as gene mutations, epigenetic variations, etc. Any etiology of adverse pregnancy outcomes and birth defects related to aging might be more than one. The detrimental effect of advanced age can be corrected to some extent by ART.
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Affiliation(s)
- Cong Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49, North garden road, Haidian district, Beijing, 100191, People's Republic of China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest (Chinese Academy of Medical Sciences), Beijing, 100191, China
- Savid Medical College (University of Chinese Academy of Sciences), Beijing, 100049, China
| | - Liying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49, North garden road, Haidian district, Beijing, 100191, People's Republic of China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest (Chinese Academy of Medical Sciences), Beijing, 100191, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49, North garden road, Haidian district, Beijing, 100191, People's Republic of China.
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China.
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China.
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China.
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest (Chinese Academy of Medical Sciences), Beijing, 100191, China.
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Sari NP, Jansen PW, Blanken LME, Ruigrok ANV, Prinzie P, Tiemeier H, Baron-Cohen S, van IJzendoorn MH, White T. Maternal age, autistic-like traits and mentalizing as predictors of child autistic-like traits in a population-based cohort. Mol Autism 2022; 13:26. [PMID: 35705965 PMCID: PMC9199218 DOI: 10.1186/s13229-022-00507-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Many empirical studies suggest that higher maternal age increases the likelihood of having an autistic child. However, little is known about factors that may explain this relationship or if higher maternal age is related to the number of autistic-like traits in offspring. One possibility is that mothers who have a higher number of autistic-like traits, including greater challenges performing mentalizing skills, are delayed in finding a partner. The goal of our study is to assess the relationship between maternal age, mentalizing skills and autistic-like traits as independent predictors of the number of autistic-like traits in offspring. Methods In a population-based study in the Netherlands, information on maternal age was collected during pre- and perinatal enrolment. Maternal mentalizing skills and autistic-like traits were assessed using the Reading the Mind in the Eyes Test and the Autism Spectrum Quotient, respectively. Autistic-like traits in children were assessed with the Social Responsiveness Scale. A total of 5718 mother/child dyads had complete data (Magechild = 13.5 years; 50.2% girls). Results The relationship between maternal age and autistic-like traits in offspring best fits a U-shaped curve. Furthermore, higher levels of autistic features in mothers are linked to higher levels of autistic-like traits in their children. Lower mentalizing performance in mothers is linked to higher levels of autistic-like traits in their children. Limitations We were able to collect data on both autistic-like traits and the mentalizing skills test in a large population of mothers, but we did not collect these data in a large number of the fathers. Conclusions The relationships between older and younger mothers may have comparable underlying mechanisms, but it is also possible that the tails of the U-shaped curve are influenced by disparate mechanisms. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-022-00507-4.
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Affiliation(s)
- Novika Purnama Sari
- Department Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands. .,Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, The Netherlands. .,Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Pauline W Jansen
- Department Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Laura M E Blanken
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Amber N V Ruigrok
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Peter Prinzie
- Department Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Marinus H van IJzendoorn
- Department Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Research Department of Clinical Educational and Health Psychology, UCL, University of London, London, UK
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
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11
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Samsury SF, Tengku Ismail TA, Hassan R. Low birth weight infant among teenage pregnancy in Terengganu, Malaysia: A cross-sectional study. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2022; 17:44-51. [PMID: 35440959 PMCID: PMC9004437 DOI: 10.51866/oa.59] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The purpose of this research is to determine the factors associated with low-birth-weight (LBW) infants in teenage pregnancy. METHODS A cross-sectional study was conducted in Terengganu, Malaysia, from January 1, 2020, to May 31, 2020. Records of teenage pregnancies in 2018 were retrieved from the Maternal Health Record Book and Pregnant Woman and Postnatal Book Registry. Simple logistic and multiple logistic regression analysis was used to analyse the factors associated with LBW infants in teenage pregnancy. RESULTS All 357 cases that fulfilled the study criteria were included. LBW infants were the most common perinatal outcome among teenage pregnancies (19.3%), followed by preterm birth (9.0 %), and both low Apgar score and stillbirth (1.4% each). Factors associated with low-birth-weight infants in teenage pregnancy in Terengganu were a teenage husband (AOR 2.0; 95% CI: 1.01, 3.96; p=0.047) and a mother with a low level of education (AOR 3.07; 95% CI: 1.20, 7.85; p=0.019). CONCLUSION Teenage husband and low level of maternal education are significant factors that need to be addressed to improve teenage pregnancy outcomes. Interventions to improve these factors should continue to be encouraged.
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Affiliation(s)
- Siti Fatimah Samsury
- MD, Master of Public Health (USM), Department of Community Medicine, School of Medical Sciences, Universiti, Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Tengku Alina Tengku Ismail
- MD (USM), PhD (USM), Department of Community Medicine, School of Medical Sciences, Universiti, Sains Malaysia, Kubang Kerian, Kelantan, Malaysia,
| | - Raihan Hassan
- MD (USM), MMed (Family Medicine), Klinik Kesihatan Kuala Besut, Besut, Terengganu, Malaysia
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12
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叶 长, 陈 生, 王 婷, 张 森, 秦 家, 陈 立. Risk factors for preterm birth: a prospective cohort study. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:1242-1249. [PMID: 34911607 PMCID: PMC8690713 DOI: 10.7499/j.issn.1008-8830.2108015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/14/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To investigate the incidence of preterm birth and risk factors for preterm birth. METHODS A prospective cohort study was performed for the pregnant women in early pregnancy and their spouses, who underwent prenatal examination for the first time in Hunan Provincial Maternal and Child Health Care Hospital from May 2014 to December 2016 and decided to be hospitalized for delivery. A questionnaire survey was performed to collect exposure information possibly related to preterm birth. The hospital's medical record system was used for information verification and to record the pregnancy outcome. A multivariate logistic regression analysis was used to investigate the risk factors for preterm birth. RESULTS A total of 6 764 pregnant women with complete data were included, and the incidence rate of preterm birth was 17.09%. The multivariate logistic regression analysis showed that a history of adverse pregnancy outcomes, eating areca nut before pregnancy, a history of pregnancy complications, a history of hepatitis, no folate supplementation during pregnancy, medication during pregnancy, active smoking and passive smoking during pregnancy, drinking during pregnancy, unbalanced diet during pregnancy, high-intensity physical activity during pregnancy, and natural conception after treatment of infertility or assisted conception as the way of conception were risk factors for preterm birth (P<0.05). Additionally, the pregnant women whose spouses were older, had a higher body mass index or smoked had an increased risk for preterm birth (P<0.05). A higher level of education of pregnant women or their spouses and lower gravidity were protective factors against preterm birth (P<0.05). CONCLUSIONS There are many risk factors for preterm birth. Special attention should be paid to the life behaviors of pregnant women during pregnancy, and health education should be strengthened for pregnant women and their spouses to develop good living habits and reduce the incidence of preterm births.
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Affiliation(s)
| | | | - 婷婷 王
- 湖南省妇幼保健院国家卫健委出生缺陷研究与预防重点实验室,湖南长沙410008
| | | | - 家碧 秦
- 临床流行病学湖南省 重点实验室,湖南长沙410078
| | - 立章 陈
- 临床流行病学湖南省 重点实验室,湖南长沙410078
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13
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Xia Z, Wang C, Hancock R, Vandermosten M, Hoeft F. Development of thalamus mediates paternal age effect on offspring reading: A preliminary investigation. Hum Brain Mapp 2021; 42:4580-4596. [PMID: 34219304 PMCID: PMC8410543 DOI: 10.1002/hbm.25567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/31/2021] [Accepted: 06/13/2021] [Indexed: 12/20/2022] Open
Abstract
The importance of (inherited) genetic impact in reading development is well established. De novo mutation is another important contributor that is recently gathering interest as a major liability of neurodevelopmental disorders, but has been neglected in reading research to date. Paternal age at childbirth (PatAGE) is known as the most prominent risk factor for de novo mutation, which has been repeatedly shown by molecular genetic studies. As one of the first efforts, we performed a preliminary investigation of the relationship between PatAGE, offspring's reading, and brain structure in a longitudinal neuroimaging study following 51 children from kindergarten through third grade. The results showed that greater PatAGE was significantly associated with worse reading, explaining an additional 9.5% of the variance after controlling for a number of confounds-including familial factors and cognitive-linguistic reading precursors. Moreover, this effect was mediated by volumetric maturation of the left posterior thalamus from ages 5 to 8. Complementary analyses indicated the PatAGE-related thalamic region was most likely located in the pulvinar nuclei and related to the dorsal attention network by using brain atlases, public datasets, and offspring's diffusion imaging data. Altogether, these findings provide novel insights into neurocognitive mechanisms underlying the PatAGE effect on reading acquisition during its earliest phase and suggest promising areas of future research.
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Affiliation(s)
- Zhichao Xia
- Department of Psychiatry and Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain ResearchBeijing Normal UniversityBeijingChina
- School of Systems ScienceBeijing Normal UniversityBeijingChina
| | - Cheng Wang
- Department of Psychiatry and Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Roeland Hancock
- Department of Psychological Sciences and Brain Imaging Research CenterUniversity of ConnecticutStorrsConnecticutUSA
| | - Maaike Vandermosten
- Department of Psychiatry and Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of NeuroscienceExperimental ORL, KU LeuvenLeuvenBelgium
| | - Fumiko Hoeft
- Department of Psychiatry and Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of Psychological Sciences and Brain Imaging Research CenterUniversity of ConnecticutStorrsConnecticutUSA
- Haskins LaboratoriesNew HavenConnecticutUSA
- Department of NeuropsychiatryKeio University School of MedicineShinjuku‐kuTokyoJapan
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Parental age and preterm birth: a population-based cohort of nearly 3 million California livebirths from 2007 to 2012. J Perinatol 2021; 41:2156-2164. [PMID: 33293667 DOI: 10.1038/s41372-020-00894-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/15/2020] [Accepted: 11/20/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE To assess the relationships between parental ages and preterm birth subtypes. METHODS A population-based cohort analysis of California livebirths 2007-2012. Associations between maternal and paternal age with spontaneous and medically indicated preterm birth were estimated from Cox proportional hazard models. Parental age was modeled with restricted cubic splines to account for nonlinear relationships. RESULTS Young paternal age was associated with increased hazard ratios for spontaneous and medically indicated preterm birth. Older fathers showed elevated hazards for preterm birth in crude analysis but after adjustment the relationship was generally not observed. Aging mothers showed increased hazard ratios for both preterm birth phenotypes. CONCLUSIONS After adjusting for parental demographics, births to younger fathers and older mothers had the highest risks for spontaneous preterm birth. The paternal influence on preterm birth was observed to be independent of maternal factors.
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15
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Rahman MM, Ara T, Mahmud S, Samad N. Revisit the correlates of infant mortality in Bangladesh: findings from two nationwide cross-sectional studies. BMJ Open 2021; 11:e045506. [PMID: 34385233 PMCID: PMC8362712 DOI: 10.1136/bmjopen-2020-045506] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The main objective of this study is to investigate how the direction and strength of the association between infant mortality and its predictors are changing over time in Bangladesh using a nationally representative sample for the period 2011-2014. DESIGN, SETTING AND PARTICIPANTS Data from two repeatedly cross-sectional Bangladesh Demographic and Health Surveys (BDHSs) for the years 2011 and 2014 were used. A total of 7664 (with 312 infant death) and 7048 (with 264 infant death) complete cases, respectively, from BDHS 2011 and 2014 datasets were included in the study. METHODS Cox's proportional hazard model with robust standard error (SE) that adjusts for the complex survey design characteristics was implemented to assess how the risk factors associated with infant mortality change their paths. RESULTS Results reflected that administrative division remained as a potential risk factor of infant death for both periods. Household's socioeconomic status, father's employment status, age difference between parents turned out to be potential risk factors in 2014, though they did not show any significant association with infant death in the year 2011. In contrast to 2011, mothers' individual-level characteristics such as age at childbirth, education, media exposure, employment status did not remain as significant risk factors for infant death in 2014. Younger fathers increased the burden of death among infants of adolescent mothers. At higher order births, the burden of infant death significantly shifted from rural to urban areas. From the year 2011 to 2014, urban areas achieved socioeconomic equity in infant survival, while the extent of inequity was increased in rural areas. CONCLUSION Community-based programmes should be designed for urban mothers who are expecting higher order births. To eradicate the socioeconomic inequity in infant survival, the government should design strong and sustainable maternal and child healthcare facilities, especially for rural areas.
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Affiliation(s)
- Md Mahabubur Rahman
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Tasnim Ara
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Sultan Mahmud
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Nandeeta Samad
- Department of Public Health, North South University, Dhaka, Bangladesh
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16
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Kong P, Liu Y, Zhu Q, Yin M, Teng X. Effect of male age on pregnancy and neonatal outcomes in the first frozen-thawed embryo transfer cycles of IVF/ICSI treatment. Andrology 2021; 9:1540-1548. [PMID: 33961339 DOI: 10.1111/andr.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 04/19/2021] [Accepted: 05/04/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The effect of male age on pregnancy outcomes after assisted reproductive technology (ART) treatment shown in the previous literature is controversial. In addition, the influence of male age on neonatal outcomes following ART treatment has less been investigated. OBJECTIVES The aim of this study was to evaluate the effect of male age on reproductive and neonatal outcomes in couples following ART treatment. MATERIALS AND METHODS A retrospective cohort study was performed in two centers for assisted reproduction from June 2010 to February 2019. A total of 5512 frozen-thawed embryo transfer (FET) cycles were included according to the criteria. The primary outcome measures were pregnancy and neonatal outcomes. Patients were categorized into five groups according to male age (younger than 30, 31-35, 36-40, 41-45, and older than 45), and the group younger than 30 years old was treated as the reference group. RESULTS The logistic regression analysis showed that clinical pregnancy and live birth were all no statistic difference among the male age-groups compared with the reference group (p values, 0.743, 0.979, 0.948, 0.28; p values, 0.823, 0.342, 0.817, 0.381, respectively). Furthermore, no significant differences were found in the preterm birth rate, child sex, neonatal malformation, birth weight, and gestational age (p > 0.05). The advanced male age was not associated with a higher risk of adverse neonatal outcomes. DISCUSSION AND CONCLUSION This study showed that there were no effects of male age on pregnancy or neonatal outcomes in infertile couples following their first FET cycles when females were younger than 36 years old.
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Affiliation(s)
- Pengcheng Kong
- Department of Assisted Reproduction, First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yanan Liu
- Department of Assisted Reproduction, First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qianqian Zhu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingru Yin
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoming Teng
- Department of Assisted Reproduction, First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
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Lazzari E. Pathways into childbearing delay of men and women in Australia. LONGITUDINAL AND LIFE COURSE STUDIES : INTERNATIONAL JOURNAL 2021; 13:307-334. [PMID: 35920646 DOI: 10.1332/175795921x16197735939121] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Childbearing delay is a pervasive feature of Australian society, but little research has been conducted to examine how socio-economic factors are linked to childbearing timing among Australian men and women. This paper addresses this by analysing the timing of first childbirth for a large sample of Australian residents (N = 4,444). The findings indicate that childbearing delay is socially patterned and that life course experiences shape the risk of delaying childbearing across genders. Having a tertiary qualification delays the transition to parenthood, especially for women. An uninterrupted career prolongs time to parenthood for women but accelerates it for men. Low occupational prestige, being married and having been in only one co-residential union are associated with earlier parenthood for both men and women. For each increase in education level, not being married is associated with increasing levels of childlessness. Clear-cut gender differences are found in the relationship between childlessness and childbearing delay.
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Halvaei I, Litzky J, Esfandiari N. Advanced paternal age: effects on sperm parameters, assisted reproduction outcomes and offspring health. Reprod Biol Endocrinol 2020; 18:110. [PMID: 33183337 PMCID: PMC7664076 DOI: 10.1186/s12958-020-00668-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/30/2020] [Indexed: 01/08/2023] Open
Abstract
Many factors, including postponement of marriage, increased life expectancy, and improved success with assisted reproductive technologies have been contributing to increased paternal age in developed nations. This increased average paternal age has led to concerns about adverse effects of advanced paternal age on sperm quality, assisted reproductive outcomes, and the health of the offspring conceived by older fathers. This review discusses the association between advanced paternal age and sperm parameters, assisted reproduction success rates, and offspring health.
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Affiliation(s)
- Iman Halvaei
- Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Julia Litzky
- Department of Pediatrics, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Navid Esfandiari
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont Medical Center, Larner College of Medicine, 111 Colchester Ave, Burlington, VT, 05401, USA.
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Novel sex-specific influence of parental factors on small-for-gestational-age newborns. Sci Rep 2020; 10:19226. [PMID: 33154528 PMCID: PMC7644766 DOI: 10.1038/s41598-020-76196-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/23/2020] [Indexed: 11/09/2022] Open
Abstract
Since fetal programming is sex-specific, there may also be sex-specific in parental influences on newborn birth weight. We aimed to investigate the influence of parental factors on small-for-gestational-age (SGA) infants of different sexes. Based on a pre-pregnancy cohort, multivariate logistic regression was used. 2275 couples were included for analysis. Significant associations were observed among paternal height, pre-pregnancy body mass index (BMI), and SGA in male infants; among maternal height, pre-pregnancy BMI, and SGA in female infants, and among other maternal factors and SGA in both male and female infants. Such sex specificity may be related to genetic, epigenetic, or hormonal influences between parents and infants. In conclusion, there is a sex specificity in the effect of parental height and pre-pregnancy BMI on SGA. The data suggest that future studies on infants should consider the sex-specific differences between the effects of genetic or environmental factors and infants.
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Wu H, Zhao M, Liang Y, Xi B. Association between paternal age and offspring's under-5 mortality: Data from 159 surveys in 67 low- to middle-income countries. J Paediatr Child Health 2020; 56:1577-1583. [PMID: 32804437 DOI: 10.1111/jpc.15029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/27/2020] [Accepted: 06/02/2020] [Indexed: 01/03/2023]
Abstract
AIM To investigat the association between paternal age at birth and offspring's under-5 mortality in low- and middle-income countries (LIMCs). METHODS Data from 159 population-based surveys in 67 LIMCs between 2000 and 2018 were obtained from the Demographic and Health Surveys. Cox proportional hazard regression models in consideration of complex survey design were performed to examine the associations. RESULTS In the pooled analysis, compared with children born to fathers aged 25-29 years, those born to younger fathers aged 20-24, 16-19 and 12-15 years, respectively, were at increased risk of under-5 mortality (hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.06-1.13; HR = 1.48, 95% CI = 1.42-1.55; HR = 1.70, 95% CI = 1.56-1.84, respectively). In addition, children born to older fathers aged 40-44 and ≥ 45 years, also had increased risk of under-5 mortality (HR = 1.08, 95% CI = 1.03-1.15; HR = 1.12, 95% CI = 1.07-1.18, respectively). CONCLUSIONS Our findings show that children born to both younger and older fathers are at higher risk of offspring's under-5 mortality in LIMCs.
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Affiliation(s)
- Han Wu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China
| | - Yajun Liang
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
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Lyall K, Song L, Botteron K, Croen LA, Dager SR, Fallin MD, Hazlett HC, Kauffman E, Landa R, Ladd-Acosta C, Messinger DS, Ozonoff S, Pandey J, Piven J, Schmidt RJ, Schultz RT, Stone WL, Newschaffer CJ, Volk HE. The Association Between Parental Age and Autism-Related Outcomes in Children at High Familial Risk for Autism. Autism Res 2020; 13:998-1010. [PMID: 32314879 PMCID: PMC7396152 DOI: 10.1002/aur.2303] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Abstract
Advanced parental age is a well-replicated risk factor for autism spectrum disorder (ASD), a neurodevelopmental condition with a complex and not well-defined etiology. We sought to determine parental age associations with ASD-related outcomes in subjects at high familial risk for ASD. A total of 397 younger siblings of a child with ASD, drawn from existing prospective high familial risk cohorts, were included in these analyses. Overall, we did not observe significant associations of advanced parental age with clinical ASD diagnosis, Social Responsiveness Scale, or Vineland Adaptive Behavior Scales scores. Instead, increased odds of ASD were found with paternal age < 30 years (adjusted odds ratio [AOR] = 2.83 and 95% confidence intervals [CI] = 1.14-7.02). Likewise, younger age (<30 years) for both parents was associated with decreases in Mullen Scales of Early Learning early learning composite (MSEL-ELC) scores (adjusted β = -9.62, 95% CI = -17.1 to -2.15). We also found significant increases in cognitive functioning based on MSEL-ELC scores with increasing paternal age (adjusted β associated with a 10-year increase in paternal age = 5.51, 95% CI = 0.70-10.3). Results suggest the potential for a different relationship between parental age and ASD-related outcomes in families with elevated ASD risk than has been observed in general population samples. Autism Res 2020, 13: 998-1010. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Previous work suggests that older parents have a greater likelihood of having a child with autism. We investigated this relationship in the younger siblings of families who already had a child with autism. In this setting, we found a higher likelihood of autism, as well as poorer cognitive scores, in the siblings with younger fathers, and higher cognitive scores in the siblings with older parents. These results suggest that parental age associations may differ based on children's familial risk for autism.
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Affiliation(s)
- Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lanxin Song
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Kelly Botteron
- Department of Psychiatry, Washington University, St Louis, Missouri, USA
| | - Lisa A Croen
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - M Daniele Fallin
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Heather C Hazlett
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Elizabeth Kauffman
- AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Rebecca Landa
- Department of Psychiatry and Behavioral Sciences, Center for Autism and Related Disorders, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Maryland, USA
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Sally Ozonoff
- MIND Institute, Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, California, USA
| | - Juhi Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rebecca J Schmidt
- Department of Public Health, University of California Davis, Davis, California, USA
- MIND Institute, University of California Davis, Sacramento, California, USA
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Wendy L Stone
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Craig J Newschaffer
- College of Health and Human Development, Pennsylvania State University, State College, Pennsylvania, USA
| | - Heather E Volk
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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22
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Wadhawan I, Hai Y, Foyouzi Yousefi N, Guo X, Graham JM, Rosenfeld JA. De novo copy number variants and parental age: Is there an association? Eur J Med Genet 2019; 63:103829. [PMID: 31883480 DOI: 10.1016/j.ejmg.2019.103829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 10/10/2019] [Accepted: 12/21/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate whether increased parental age is associated with an increased risk for de novo copy number variant (CNV) formation in offspring. METHODS CNV calls from 2323 individuals referred to Signature Genomic Laboratories for clinical microarray-based comparative genomic hybridization were investigated; 17% of the samples were prenatal and 83% were postnatal. The de novo CNV data were further split into de novo CNVs bound by low copy repeats (LCRs) and those not bound by LCRs. RESULTS No association was found between CNV occurrence and paternal age in both the prenatal (p = 0.6795) and postnatal (p = 0.1741) cohorts. Maternal age was significantly higher with de novo CNV occurrence in our postnatal cohort (p = 0.0126), an effect which may be driven by formation of de novo CNVs that are bound by LCRs (p = 0.0026). Furthermore, a significant positive correlation was observed between maternal age and de novo CNVs (Point-Biserial R2 = 0.0503, p = 0.0152). CONCLUSIONS This large-scale study did not find any evidence for the influence of increased paternal age on de novo CNV formation, while increased maternal age appeared to increase risk for de novo, non-complex CNV occurrence in offspring with intellectual disability/developmental delay. Further studies and continued technological advances will help yield more information on the risk factors for de novo CNVs.
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Affiliation(s)
- Isha Wadhawan
- Department of Obstetrics & Gynecology, Sant Parmanand Hospital, New Delhi, India
| | - Yang Hai
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Statistics, University of Auckland, Auckland, New Zealand
| | | | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - John M Graham
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Pediatrics, Division of Medical Genetics, Cedars-Sinai Medical Center, UCLA School of Medicine, Los Angeles, CA, USA
| | - Jill A Rosenfeld
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
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Xavier MJ, Roman SD, Aitken RJ, Nixon B. Transgenerational inheritance: how impacts to the epigenetic and genetic information of parents affect offspring health. Hum Reprod Update 2019; 25:518-540. [DOI: 10.1093/humupd/dmz017] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/19/2019] [Accepted: 04/04/2019] [Indexed: 12/18/2022] Open
Abstract
Abstract
BACKGROUND
A defining feature of sexual reproduction is the transmission of genomic information from both parents to the offspring. There is now compelling evidence that the inheritance of such genetic information is accompanied by additional epigenetic marks, or stable heritable information that is not accounted for by variations in DNA sequence. The reversible nature of epigenetic marks coupled with multiple rounds of epigenetic reprogramming that erase the majority of existing patterns have made the investigation of this phenomenon challenging. However, continual advances in molecular methods are allowing closer examination of the dynamic alterations to histone composition and DNA methylation patterns that accompany development and, in particular, how these modifications can occur in an individual’s germline and be transmitted to the following generation. While the underlying mechanisms that permit this form of transgenerational inheritance remain unclear, it is increasingly apparent that a combination of genetic and epigenetic modifications plays major roles in determining the phenotypes of individuals and their offspring.
OBJECTIVE AND RATIONALE
Information pertaining to transgenerational inheritance was systematically reviewed focusing primarily on mammalian cells to the exclusion of inheritance in plants, due to inherent differences in the means by which information is transmitted between generations. The effects of environmental factors and biological processes on both epigenetic and genetic information were reviewed to determine their contribution to modulating inheritable phenotypes.
SEARCH METHODS
Articles indexed in PubMed were searched using keywords related to transgenerational inheritance, epigenetic modifications, paternal and maternal inheritable traits and environmental and biological factors influencing transgenerational modifications. We sought to clarify the role of epigenetic reprogramming events during the life cycle of mammals and provide a comprehensive review of how the genomic and epigenomic make-up of progenitors may determine the phenotype of its descendants.
OUTCOMES
We found strong evidence supporting the role of DNA methylation patterns, histone modifications and even non-protein-coding RNA in altering the epigenetic composition of individuals and producing stable epigenetic effects that were transmitted from parents to offspring, in both humans and rodent species. Multiple genomic domains and several histone modification sites were found to resist demethylation and endure genome-wide reprogramming events. Epigenetic modifications integrated into the genome of individuals were shown to modulate gene expression and activity at enhancer and promoter domains, while genetic mutations were shown to alter sequence availability for methylation and histone binding. Fundamentally, alterations to the nuclear composition of the germline in response to environmental factors, ageing, diet and toxicant exposure have the potential to become hereditably transmitted.
WIDER IMPLICATIONS
The environment influences the health and well-being of progeny by working through the germline to introduce spontaneous genetic mutations as well as a variety of epigenetic changes, including alterations in DNA methylation status and the post-translational modification of histones. In evolutionary terms, these changes create the phenotypic diversity that fuels the fires of natural selection. However, rather than being adaptive, such variation may also generate a plethora of pathological disease states ranging from dominant genetic disorders to neurological conditions, including spontaneous schizophrenia and autism.
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Affiliation(s)
- Miguel João Xavier
- Reproductive Science Group, Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Reproductive Science, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Shaun D Roman
- Reproductive Science Group, Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Reproductive Science, The University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Chemical Biology and Clinical Pharmacology, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - R John Aitken
- Reproductive Science Group, Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Reproductive Science, The University of Newcastle, Callaghan, NSW 2308, Australia
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Brett Nixon
- Reproductive Science Group, Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Reproductive Science, The University of Newcastle, Callaghan, NSW 2308, Australia
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24
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Bamishigbin ON, Dunkel Schetter C, Stanton AL. The antecedents and consequences of adolescent fatherhood: A systematic review. Soc Sci Med 2019; 232:106-119. [DOI: 10.1016/j.socscimed.2019.04.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 03/30/2019] [Accepted: 04/19/2019] [Indexed: 10/27/2022]
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25
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Oldereid NB, Wennerholm UB, Pinborg A, Loft A, Laivuori H, Petzold M, Romundstad LB, Söderström-Anttila V, Bergh C. The effect of paternal factors on perinatal and paediatric outcomes: a systematic review and meta-analysis. Hum Reprod Update 2018; 24:320-389. [PMID: 29471389 DOI: 10.1093/humupd/dmy005] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/21/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Maternal factors, including increasing childbearing age and various life-style factors, are associated with poorer short- and long-term outcomes for children, whereas knowledge of paternal parameters is limited. Recently, increasing paternal age has been associated with adverse obstetric outcomes, birth defects, autism spectrum disorders and schizophrenia in children. OBJECTIVE AND RATIONALE The aim of this systematic review is to describe the influence of paternal factors on adverse short- and long-term child outcomes. SEARCH METHODS PubMed, Embase and Cochrane databases up to January 2017 were searched. Paternal factors examined included paternal age and life-style factors such as body mass index (BMI), adiposity and cigarette smoking. The outcome variables assessed were short-term outcomes such as preterm birth, low birth weight, small for gestational age (SGA), stillbirth, birth defects and chromosomal anomalies. Long-term outcome variables included mortality, cancers, psychiatric diseases/disorders and metabolic diseases. The systematic review follows PRISMA guidelines. Relevant meta-analyses were performed. OUTCOMES The search included 14 371 articles out of which 238 met the inclusion criteria, and 81 were included in quantitative synthesis (meta-analyses). Paternal age and paternal life-style factors have an association with adverse outcome in offspring. This is particularly evident for psychiatric disorders such as autism, autism spectrum disorders and schizophrenia, but an association is also found with stillbirth, any birth defects, orofacial clefts and trisomy 21. Paternal height, but not BMI, is associated with birth weight in offspring while paternal BMI is associated with BMI, weight and/or body fat in childhood. Paternal smoking is found to be associated with an increase in SGA, birth defects such as congenital heart defects, and orofacial clefts, cancers, brain tumours and acute lymphoblastic leukaemia. These associations are significant although moderate in size, with most pooled estimates between 1.05 and 1.5, and none exceeding 2.0. WIDER IMPLICATIONS Although the increased risks of adverse outcome in offspring associated with paternal factors and identified in this report represent serious health effects, the magnitude of these effects seems modest.
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Affiliation(s)
- Nan B Oldereid
- Livio IVF-klinikken Oslo, Sørkedalsveien 10A, 0369 Oslo, Norway
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital East, SE 416 85 Gothenburg, Sweden
| | - Anja Pinborg
- Department of Obstetrics and Gynecology, Hvidovre Hospital, Institute of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Loft
- Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Hannele Laivuori
- Department of Obstetrics and Gynecology, Tampere University Hospital, Teiskontie 35, FI-33521 Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Arvo Ylpön katu 34, FI-33520 Tampere, Finland.,Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 8, FI-00290 Helsinki, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Tukhomankatu 8, FI-00290 Helsinki, Finland
| | - Max Petzold
- Swedish National Data Service and Health Metrics Unit, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Liv Bente Romundstad
- Spiren Fertility Clinic, Norwegian University of Science and Technology, Trondheim NO-7010, Norway.,Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
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26
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Khandwala YS, Baker VL, Shaw GM, Stevenson DK, Lu Y, Eisenberg ML. Association of paternal age with perinatal outcomes between 2007 and 2016 in the United States: population based cohort study. BMJ 2018; 363:k4372. [PMID: 30381468 PMCID: PMC6207919 DOI: 10.1136/bmj.k4372] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the impact of advanced paternal age on maternal and perinatal outcomes in the United States. DESIGN Retrospective, population based cohort study. SETTING US. POPULATION 40 529 905 documented live births between 2007 and 2016. MAIN OUTCOME MEASURES Primary perinatal outcomes were gestational age, birth weight, Apgar score at five minutes, admission to a neonatal intensive care unit, need for postpartum antibiotics, and seizures. Primary maternal outcomes were gestational diabetes and pre-eclampsia. Secondary outcome was the number of preventable perinatal events. RESULTS Higher paternal age was associated with an increased risk of premature birth, low birth weight, and low Apgar score. After adjustment for maternal age, infants born to fathers aged 45 years or older had 14% higher odds of premature birth (odds ratio 1.14, 95% confidence interval 1.13 to 1.15), independent of gestational age, and 18% higher odds of seizures (1.18, 0.97 to 1.44) compared with infants of fathers aged 25 to 34 years. The odds of gestational diabetes was 34% higher (1.34, 1.29 to 1.38) in mothers with the oldest partners. 13.2% (95% confidence interval 12.5% to 13.9%) of premature births and 18.2% (17.5% to 18.9%) of gestational diabetes in births associated with older fathers were estimated to be attributable to advanced paternal age. CONCLUSIONS Advanced paternal age is associated with negative effects on both mothers and offspring. Given the relatively low prevalence of advanced paternal age in the US, population level impacts are currently modest. Nevertheless, as advanced paternal age has doubled in the US over the past generation, further investigation is warranted of the impact on birth outcomes and public health.
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Affiliation(s)
- Yash S Khandwala
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305-5118, USA
| | - Valerie L Baker
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Gary M Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - David K Stevenson
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Ying Lu
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305-5118, USA
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
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27
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Shen M. The effects of school desegregation on infant health. ECONOMICS AND HUMAN BIOLOGY 2018; 30:104-118. [PMID: 30015292 DOI: 10.1016/j.ehb.2018.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/02/2018] [Accepted: 06/04/2018] [Indexed: 06/08/2023]
Abstract
This paper examines the effects of school desegregation on infant health using birth certificate data from 1970 to 2002 and a multiple difference-in-differences approach that exploits variation in the timing of desegregation across counties. Using cohort fixed effects and county fixed effects, I find that among black mothers in Southern regions, school desegregation reduces preterm births by 1.7 percentage points. These results are robust to county-specific cohort trends, county-specific year trends, and state-specific cohort fixed effects. In addition, school desegregation increases maternal education and prenatal care in the first trimester and decreases the likelihood of the child having a teenage father. These may be important pathways to improved infant health. This paper adds to the growing literature on the importance of school desegregation in areas beyond academic achievement.
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Affiliation(s)
- Menghan Shen
- Waseda Institute for Advanced Study, Waseda University, 1-6-1 Nishi Waseda, Shinjuku-ku, Tokyo 169-8050, Japan.
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28
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Goisis A, Remes H, Barclay K, Martikainen P, Myrskylä M. Paternal age and the risk of low birth weight and preterm delivery: a Finnish register-based study. J Epidemiol Community Health 2018; 72:1104-1109. [PMID: 30100579 PMCID: PMC6252372 DOI: 10.1136/jech-2017-210170] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 07/11/2018] [Accepted: 07/18/2018] [Indexed: 11/17/2022]
Abstract
Background Based on existing studies, there is no conclusive evidence as to whether and why paternal age matters for birth outcomes. Methods We used Finnish population registers on 106 652 children born 1987–2000. We first document the unadjusted association between paternal age and the risk of low birth weight (LBW; <2500 g) and preterm birth (<37 weeks’ gestation). Second, we investigate whether the unadjusted association is attenuated on adjustment for child’s, maternal and parental socioeconomic characteristics. Third, by adopting a within-family design which involves comparing children born to the same father at different ages, we additionally adjust for unobserved parental characteristics shared between siblings. Results The unadjusted results show that being born to a father aged 40+, as opposed to a father aged 30–34, is associated with an increased risk of LBW of 0.96% (95% CI 0.5% to 1.3%) and to a younger father (<25) with a 1% (95% CI 0.6% to 1.3%) increased risk. The increased risk at younger paternal ages is halved on adjustment for the child’s characteristics and fully attenuated on adjustment for child/parental characteristics. The increased risk at paternal ages 40+ is partially attenuated on adjustment for maternal characteristics (β=0.62%; 95% CI 0.13% to 1.1%). Adjustment for unobserved parental characteristics shared by siblings further attenuates the 40+ coefficient (β=0.4%; 95% CI −0.5% to −1.2%). Results for preterm delivery are similar. Conclusions The results underscore the importance of considering paternal age as a potential risk factor for adverse birth outcomes and of expanding research on its role and the mechanisms linking it to birth outcomes.
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Affiliation(s)
- Alice Goisis
- Social Policy Department, London School of Economics and Political Science, London, UK.,Max Planck Institute for Demographic Research, Rostock, Germany
| | - Hanna Remes
- Department of Sociology, University of Helsinki, Helsinki, Finland
| | - Kieron Barclay
- Social Policy Department, London School of Economics and Political Science, London, UK.,Max Planck Institute for Demographic Research, Rostock, Germany.,Department of Sociology, Stockholm University, Stockholm, Sweden
| | - Pekka Martikainen
- Max Planck Institute for Demographic Research, Rostock, Germany.,Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland.,Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden
| | - Mikko Myrskylä
- Social Policy Department, London School of Economics and Political Science, London, UK.,Max Planck Institute for Demographic Research, Rostock, Germany.,Social Statistics and Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland
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29
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Defeudis G, Mazzilli R, Gianfrilli D, Lenzi A, Isidori AM. The CATCH checklist to investigate adult-onset hypogonadism. Andrology 2018; 6:665-679. [PMID: 29888533 DOI: 10.1111/andr.12506] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 12/18/2022]
Abstract
Adult-onset hypogonadism is a syndrome often underdiagnosed, undertreated, or incompletely explored. There are various reasons for this: firstly, undefined age range of men in whom testosterone levels should be investigated and then no definitive serum cutoff point for the diagnosis of hypogonadism; and finally, variable and non-specific signs and symptoms; men and physicians do not pay adequate attention to sexual health. All these factors make the diagnostic criteria for hypogonadism controversial. The evaluation of the clinical features and causes of this syndrome, its link with age, the role of testosterone and other hormone levels, and the presence of any comorbidities are all useful factors in the investigation of this population. The purpose of this manuscript, after an accurate analysis of current literature, is to facilitate the diagnosis of hypogonadism in men through the use of the CATCH acronym and a checklist to offer a practical diagnostic tool for daily clinical practice. A narrative review of the relevant literature regarding the diagnosis of late-onset hypogonadism or adult-onset hypogonadism was performed. PubMed database was used to retrieve articles published on this topic. A useful new acronym CATCH (Clinical features [symptoms] and Causes, Age, Testosterone level, Comorbidities, and Hormones) and a practical checklist to facilitate the evaluation of hypogonadism in aging men were used. The evaluation of the clinical features and causes of hypogonadism, the link with age, the role of Testosterone and other hormones, and the evaluation of comorbidities are important in investigating adult-onset hypogonadism. The CATCH checklist could be helpful for clinicians for an early diagnosis of both hypogonadism and associated comorbidities. We suggest the use of this acronym to advocate the investigation of declining testosterone in aging men.
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Affiliation(s)
- G Defeudis
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.,Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - R Mazzilli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - D Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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30
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Children born to mothers in their 20s and fathers in their 40s: Evidence for an increased low birth weight and Cesarean Section deliveries in Lebanon. Ann Epidemiol 2018; 28:368-371. [PMID: 29803236 DOI: 10.1016/j.annepidem.2018.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 04/05/2018] [Accepted: 04/08/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Much less is known about the effect of advanced paternal age (APA) (≥40 years) than advanced maternal age on neonatal morbidity. More specifically, the correlation with low birth weight remains inconsistent. This study aims to determine whether APA among mothers aged 20-29 years is associated with a higher risk of low birth weight and other neonatal outcomes. METHODS Data from 2004 to 2008 database of the National Collaborative Perinatal Neonatal Network were used. Fifteen thousand two hundred eighteen live birth singleton pregnancies by primigravida mothers aged 20-29 years were analyzed. Study variables include paternal age (years), C-section delivery (yes/no), low birth weight (<2500 g), and preterm births (<37 weeks of gestation). Regressions were generated controlling for birth defects, consanguinity, maternal education, prenatal care, gender, and maternal smoking. RESULTS Adjusted odds of Low Birth Weight (LBW) and Cesarean Section Deliveries (CSD) were significantly higher in infants of APA fathers compared to those of fathers aged 30-35 years [adjusted odds ratio (95% confidence interval) = 1.5 (1.1, 2.3) and 1.4 (1.1, 1.7), respectively]. Paternal ages of 35-39 years compared to less than 30 years were associated with higher odds of CSD [adjusted odds ratio = 1.4 (1.2, 1.5)]. APA was not associated with preterm birth after adjustment. CONCLUSIONS This study supports the association between APA and increased risk for LBW and CSD.
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31
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Thomsen AML, Ehrenstein V, Riis AH, Toft G, Mikkelsen EM, Olsen J. The potential impact of paternal age on risk of asthma in childhood: a study within the Danish National Birth Cohort. Respir Med 2018; 137:30-34. [PMID: 29605209 DOI: 10.1016/j.rmed.2018.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/28/2018] [Accepted: 01/29/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Advanced paternal age has been associated with offspring morbidity and mortality, possibly due to de novo mutations and epigenetic changes in male germ cells. Epigenetic changes in the cord blood cells have been linked to asthma symptoms in offspring, but the role of paternal age has been less studied. METHODS From the Danish National Birth Cohort, 48,785 children who completed the 7-year follow-up were included. Parental reports of physician-diagnosed asthma had been obtained by a posted or web-based questionnaire. Paternal age at delivery was obtained through linkage with maternal civil registration number in the Danish Civil Registration System and classified into four groups: ≤24, 25-34 (reference), 35-39, and >40 years. We calculated the prevalence proportion of asthma and prevalence ratios (PRs) with 95% confidence intervals (CIs) using log-binomial regression, adjusting for paternal smoking, paternal asthma, and paternal socioeconomic status. RESULTS At the 7-year follow-up, 5875 children (12%) had physician-diagnosed asthma. The prevalence of asthma in 7-year old children was higher with paternal age of ≤24 (adjusted PR 1.40; 95% CI: 1.26; 1.55) and lower with the paternal age of ≥35 years (adjusted PR 0.84; 95% CI: 0.78; 0.89) compared to the reference group. CONCLUSIONS Paternal age of ≥35 years was associated with a lower prevalence of asthma in childhood, and paternal age of ≤24 years with higher prevalence compared with paternal age of 25-34 years. The potential causes of higher asthma prevalence among offspring of young fathers warrant further investigation.
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Affiliation(s)
- Anne Marie L Thomsen
- Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark.
| | - Vera Ehrenstein
- Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Anders Hammerich Riis
- Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Gunnar Toft
- Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Ellen M Mikkelsen
- Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark
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Iqbal AM, Schwenk WF, Theall KP. A Rare Presentation of the Syndrome of Inappropriate Antidiuretic Hormone in a 12-Year-Old Girl as the Initial Presentation of an Immature Ovarian Teratoma. J Pediatr Adolesc Gynecol 2018; 31:62-63. [PMID: 28818586 DOI: 10.1016/j.jpag.2017.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/01/2017] [Accepted: 08/06/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Immature ovarian teratoma is very rare in childhood. We report on a 12-year-old girl with immature ovarian teratoma who presented initially with syndrome of inappropriate antidiuretic hormone. CASE A 12-year-old girl presented with acute abdomen and distention. Initial laboratory tests showed hyponatremia (sodium, 123 mmol/L), that did not respond to fluid management. Computed tomography imaging showed a 15 cm × 9 cm × 20 cm mass in the right ovary with multifocal internal fat, and dystrophic calcifications. She underwent exploratory laparotomy with a right salpingo-oophorectomy, omentectomy, and peritoneal stripping. The pathology revealed metastatic immature teratoma. Hyponatremia resolved soon after the surgery. SUMMARY AND CONCLUSION Although a rare diagnosis, immature ovarian teratoma must be considered in a girl who presents with abdominal mass and hyponatremia.
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Affiliation(s)
- Anoop Mohamed Iqbal
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
| | - W Frederick Schwenk
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
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Hurley EG, DeFranco EA. Influence of paternal age on perinatal outcomes. Am J Obstet Gynecol 2017; 217:566.e1-566.e6. [PMID: 28784418 DOI: 10.1016/j.ajog.2017.07.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/19/2017] [Accepted: 07/31/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is an increasing trend to delay childbearing to advanced parental age. Increased risks of advanced maternal age and assisted reproductive technologies are widely accepted. There are limited data regarding advanced paternal age. To adequately counsel patients on risk, more research regarding advanced paternal age is necessary. OBJECTIVE We sought to determine the influence of paternal age on perinatal outcomes, and to assess whether this influence differs between pregnancies achieved spontaneously and those achieved with assisted reproductive technology. STUDY DESIGN A population-based retrospective cohort study of all live births in Ohio from 2006 through 2012 was completed. Data were evaluated to determine if advanced paternal age is associated with an increased risk of adverse outcomes in pregnancies. The analysis was stratified by status of utilization of assisted reproductive technology. Generalized linear regression models assessed the association of paternal age on pregnancy complications in assisted reproductive technology and spontaneously conceived pregnancies, after adjusting for maternal age, race, multifetal gestation, and Medicaid status, using Stata software (Stata, Release 12; StataCorp, College Station, TX). RESULTS Paternal age was documented in 82.2% of 1,034,552 live births in Ohio during the 7-year study period. Paternal age ranged from 12-87 years, with a median of 30 (interquartile range, 26-35) years. Maternal age ranged from 11-62 years, with a median of 27 (interquartile range, 22-31) years. The use of assisted reproductive technology in live births increased as paternal age increased: 0.1% <30 years vs 2.5% >60 years, P < .001. After accounting for maternal age and other confounding risk factors, increased paternal age was not associated with a significant increase in the rate of preeclampsia, preterm birth, fetal growth restriction, congenital anomaly, genetic disorder, or neonatal intensive care unit admission. The influence of paternal age on pregnancy outcomes was similar in pregnancies achieved with and without assisted reproductive technology. CONCLUSION Older paternal age does not appear to pose an independent risk of adverse perinatal outcomes, in pregnancies achieved either with or without assisted reproductive technology. However, small effect sizes such as very small risk increases or decreases may not be detectable despite the large sample size in this study of >830,000 births.
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Janecka M, Rijsdijk F, Rai D, Modabbernia A, Reichenberg A. Advantageous developmental outcomes of advancing paternal age. Transl Psychiatry 2017; 7:e1156. [PMID: 28632201 PMCID: PMC5537646 DOI: 10.1038/tp.2017.125] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 04/20/2017] [Indexed: 12/20/2022] Open
Abstract
Advanced paternal age (APA) at conception has been associated with negative outcomes in offspring, raising concerns about increasing age at fatherhood. Evidence from evolutionary and psychological research, however, suggests possible link between APA and a phenotypic advantage. We defined such advantage as educational success, which is positively associated with future socioeconomic status. We hypothesised that high IQ, strong focus on the subject of interest and little concern about 'fitting in' will be associated with such success. Although these traits are continuously distributed in the population, they cluster together in so-called 'geeks'. We used these measures to compute a 'geek index' (GI), and showed it to be strongly predictive of future academic attainment, beyond the independent contribution of the individual traits. GI was associated with paternal age in male offspring only, and mediated the positive effects of APA on education outcomes, in a similar sexually dimorphic manner. The association between paternal age and GI was partly mediated by genetic factors not correlated with age at fatherhood, suggesting contribution of de novo factors to the 'geeky' phenotype. Our study sheds new light on the multifaceted nature of the APA effects and explores the intricate links between APA, autism and talent.
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Affiliation(s)
- M Janecka
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Seaver Autism Center for Research and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - F Rijsdijk
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - D Rai
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - A Modabbernia
- Seaver Autism Center for Research and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Reichenberg
- Seaver Autism Center for Research and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Janecka M, Haworth CM, Ronald A, Krapohl E, Happé F, Mill J, Schalkwyk LC, Fernandes C, Reichenberg A, Rijsdijk F. Paternal Age Alters Social Development in Offspring. J Am Acad Child Adolesc Psychiatry 2017; 56:383-390. [PMID: 28433087 PMCID: PMC5409803 DOI: 10.1016/j.jaac.2017.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 02/10/2017] [Accepted: 02/27/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Advanced paternal age (APA) at conception has been linked with autism and schizophrenia in offspring, neurodevelopmental disorders that affect social functioning. The current study explored the effects of paternal age on social development in the general population. METHOD We used multilevel growth modeling to investigate APA effects on socioemotional development from early childhood until adolescence, as measured by the Strengths and Difficulties Questionnaire (SDQ) in the Twins Early Development Study (TEDS) sample. We also investigated genetic and environmental underpinnings of the paternal age effects on development, using the Additive genetics, Common environment, unique Environment (ACE) and gene-environment (GxE) models. RESULTS In the general population, both very young and advanced paternal ages were associated with altered trajectory of social development (intercept: p = .01; slope: p = .03). No other behavioral domain was affected by either young or advanced age at fatherhood, suggesting specificity of paternal age effects. Increased importance of genetic factors in social development was recorded in the offspring of older but not very young fathers, suggesting distinct underpinnings of the paternal age effects at these two extremes. CONCLUSION Our findings highlight that the APA-related deficits that lead to autism and schizophrenia are likely continuously distributed in the population.
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Affiliation(s)
- Magdalena Janecka
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, UK; Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York.
| | - Claire M.A. Haworth
- MRC Integrative Epidemiology Unit, School of Experimental Psychology and School of Social and Community Medicine, University of Bristol, UK
| | | | - Eva Krapohl
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, UK
| | - Jonathan Mill
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, UK,University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Cathy Fernandes
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, UK
| | - Abraham Reichenberg
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York
| | - Frühling Rijsdijk
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, UK
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Misra DP, Slaughter-Acey J, Giurgescu C, Sealy-Jefferson S, Nowak A. Why Do Black Women Experience Higher Rates of Preterm Birth? CURR EPIDEMIOL REP 2017. [DOI: 10.1007/s40471-017-0102-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Janecka M, Mill J, Basson MA, Goriely A, Spiers H, Reichenberg A, Schalkwyk L, Fernandes C. Advanced paternal age effects in neurodevelopmental disorders-review of potential underlying mechanisms. Transl Psychiatry 2017; 7:e1019. [PMID: 28140401 PMCID: PMC5299396 DOI: 10.1038/tp.2016.294] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/23/2016] [Accepted: 12/15/2016] [Indexed: 01/09/2023] Open
Abstract
Multiple epidemiological studies suggest a relationship between advanced paternal age (APA) at conception and adverse neurodevelopmental outcomes in offspring, particularly with regard to increased risk for autism and schizophrenia. Conclusive evidence about how age-related changes in paternal gametes, or age-independent behavioral traits affect neural development is still lacking. Recent evidence suggests that the origins of APA effects are likely to be multidimensional, involving both inherited predisposition and de novo events. Here we provide a review of the epidemiological and molecular findings to date. Focusing on the latter, we present the evidence for genetic and epigenetic mechanisms underpinning the association between late fatherhood and disorder in offspring. We also discuss the limitations of the APA literature. We propose that different hypotheses relating to the origins of the APA effects are not mutually exclusive. Instead, multiple mechanisms likely contribute, reflecting the etiological complexity of neurodevelopmental disorders.
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Affiliation(s)
- M Janecka
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Mill
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - M A Basson
- Department of Craniofacial and Stem Cell Biology, MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - A Goriely
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - H Spiers
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - A Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Schalkwyk
- School of Biological Sciences, University of Essex, Colchester, UK
| | - C Fernandes
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Nybo Andersen AM, Urhoj SK. Is advanced paternal age a health risk for the offspring? Fertil Steril 2017; 107:312-318. [PMID: 28088314 DOI: 10.1016/j.fertnstert.2016.12.019] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/18/2016] [Accepted: 12/19/2016] [Indexed: 01/06/2023]
Abstract
In this article we review the epidemiologic evidence for adverse health effects in offspring of fathers of advanced age. First the evidence regarding fetal survival is addressed, and afterward we review the evidence regarding morbidity in children with older fathers. The adverse conditions most consistently associated with increased paternal age are stillbirths, musculo-skeletal syndromes, cleft palate, acute lymphoblastic leukemia and retinoblastoma, and neurodevelopmental disorders in the autism spectrum and schizophrenia. Finally, we consider the public health impact of the increasing paternal age. We conclude that the adverse health effects in children that might be caused by the present increase in paternal age are severe but quantitatively of minor importance. However, identification of morbidities that are more frequent in offspring of older fathers, after having taken any maternal age effects and other confounding into account, may lead to a better understanding of the pathogenesis behind such conditions.
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Affiliation(s)
| | - Stine Kjaer Urhoj
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Bacci S, Bartolucci F, Minelli L, Chiavarini M. Preterm Birth: Analysis of Longitudinal Data on Siblings Based on Random-Effects Logit Models. Front Public Health 2017; 4:278. [PMID: 28066757 PMCID: PMC5179574 DOI: 10.3389/fpubh.2016.00278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 12/06/2016] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION The literature about the determinants of a preterm birth is still controversial. We approach the analysis of these determinants distinguishing between woman's observable characteristics, which may change over time, and unobservable woman's characteristics, which are time invariant and explain the dependence between the typology (normal or preterm) of consecutive births. METHODS We rely on a longitudinal dataset about 28,603 women who delivered for the first time in the period 2005-2013 in the Umbria Region (Italy). We consider singleton physiological pregnancies originating from natural conceptions with birthweight of at least 500 g and gestational age between 24 and 42 weeks; the overall number of deliveries is 34,224. The dataset is based on the Standard Certificates of Life Birth collected in the region in the same period. We estimate two types of logit model for the event that the birth is preterm. The first model is pooled and accounts for the information about possible previous preterm deliveries, including the lagged response among the covariates. The second model takes explicitly into account the longitudinal structure of data through the introduction of a random effect that summarizes all the (time invariant) unobservable characteristics of a woman affecting the probability of a preterm birth. RESULTS The estimated models provide evidence that the probability of a preterm birth depends on certain woman's demographic and socioeconomic characteristics, other than on the previous history in terms of miscarriages and the baby's gender. Besides, as the random-effects model fits significantly better than the pooled model with lagged response, we conclude for a spurious state dependence between repeated preterm deliveries. CONCLUSION The proposed analysis represents a useful tool to detect profiles of women with a high risk of preterm delivery. Such profiles are detected taking into account observable woman's demographic and socioeconomic characteristics as well as unobservable and time-constant characteristics, possibly related to the woman's genetic makeup. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Silvia Bacci
- Department of Economics, University of Perugia , Perugia , Italy
| | | | - Liliana Minelli
- Department of Experimental Medicine, University of Perugia , Perugia , Italy
| | - Manuela Chiavarini
- Department of Experimental Medicine, University of Perugia , Perugia , Italy
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Paternal Factors Associated with Neonatal Deaths and Births with Low Weight: Evidence from Pakistan Demographic and Health Survey 2006–2007. Matern Child Health J 2015; 19:1634-42. [DOI: 10.1007/s10995-015-1674-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Chudal R, Gissler M, Sucksdorff D, Lehti V, Suominen A, Hinkka-Yli-Salomäki S, Brown AS, Sourander A. Parental age and the risk of bipolar disorders. Bipolar Disord 2014; 16:624-32. [PMID: 24499422 DOI: 10.1111/bdi.12182] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 10/22/2013] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Studies on the association between parental age and bipolar disorder (BPD) are scarce and with inconsistent findings. The aim of this study was to examine the association of parental age and age difference between parents with risk of BPD in offspring. METHODS This nested case-control study identified 1,861 cases of individuals with BPD born in Finland during 1983-1998 and diagnosed by the end of 2008, and 3,643 sex- and date of birth-matched controls from nationwide population-based registers. Conditional logistic regression was used to examine the association adjusting for potential confounding due to age of the other parent, parental psychiatric history, educational level, and place of birth. RESULTS A U-shaped association of unadjusted odds ratios (ORs) for BPD risk was seen in different paternal age categories, with the odds increasing at both ends of the age spectrum. In the adjusted analyses, offspring of fathers aged ≥ 50 years had a 2.8-fold increased odds [OR = 2.84, 95% confidence interval (CI): 1.32-6.12] of BPD as compared to those with fathers aged 30-34 years. The odds were increased 1.3-fold (OR = 1.35, CI: 1.06-1.72) in fathers aged 20-24 years. No significant association was found between maternal age and BPD in the adjusted analyses. Age difference between parents was not associated with BPD. CONCLUSIONS The increased risk of BPD in offspring of the youngest and oldest fathers in the study suggests the involvement of different biological and psychosocial factors at the two ends of the paternal age spectrum. These findings may be significant in the context of advancing parental age in recent times.
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Affiliation(s)
- Roshan Chudal
- Department of Child Psychiatry, University of Turku, Turku, Finland
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Moya C, Sear R. Intergenerational conflicts may help explain parental absence effects on reproductive timing: a model of age at first birth in humans. PeerJ 2014; 2:e512. [PMID: 25165627 PMCID: PMC4137655 DOI: 10.7717/peerj.512] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 07/22/2014] [Indexed: 12/05/2022] Open
Abstract
Background. Parental absences in childhood are often associated with accelerated reproductive maturity in humans. These results are counterintuitive for evolutionary social scientists because reductions in parental investment should be detrimental for offspring, but earlier reproduction is generally associated with higher fitness. In this paper we discuss a neglected hypothesis that early reproduction is often associated with parental absence because it decreases the average relatedness of a developing child to her future siblings. Family members often help each other reproduce, meaning that parents and offspring may find themselves in competition over reproductive opportunities. In these intergenerational negotiations offspring will have less incentive to help the remaining parent rear future half-siblings relative to beginning reproduction themselves. Method. We illustrate this “intergenerational conflict hypothesis” with a formal game-theoretic model. Results. We show that when resources constrain reproductive opportunities within the family, parents will generally win reproductive conflicts with their offspring, i.e., they will produce more children of their own and therefore delay existing offsprings’ reproduction. This is due to the asymmetric relatedness between grandparents and grandchildren (r = .25), compared to siblings (r = 0.5), resulting in greater incentives for older siblings to help rear younger siblings than for grandparents to help rear grandchildren. However, if a parent loses or replaces their partner, the conflict between the parent and offspring becomes symmetric since half siblings are as related to one another as grandparents are to grandchildren. This means that the offspring stand to gain more from earlier reproduction when their remaining parent would produce half, rather than full, siblings. We further show that if parents senesce in a way that decreases the quality of their infant relative to their offspring’s infant, the intergenerational conflict can shift to favor the younger generation.
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Affiliation(s)
- Cristina Moya
- Department of Population Health, London School of Hygiene and Tropical Medicine , London , United Kingdom
| | - Rebecca Sear
- Department of Population Health, London School of Hygiene and Tropical Medicine , London , United Kingdom
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Shah MK, Gee RE, Theall KP. Partner support and impact on birth outcomes among teen pregnancies in the United States. J Pediatr Adolesc Gynecol 2014; 27:14-9. [PMID: 24316120 PMCID: PMC3947023 DOI: 10.1016/j.jpag.2013.08.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 06/07/2013] [Accepted: 08/02/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE Despite hypothesized relationships between lack of partner support during a woman's pregnancy and adverse birth outcomes, few studies have examined partner support among teens. We examined a potential proxy measure of partner support and its impact on adverse birth outcomes (low birth weight (LBW), preterm birth (PTB) and pregnancy loss) among women who have had a teenage pregnancy in the United States. METHODS In a secondary data analysis utilizing cross-sectional data from 5609 women who experienced a teen pregnancy from the 2006-2010 National Survey of Family Growth (NSFG), we examined an alternative measure of partner support and its impact on adverse birth outcomes. Bivariate and multivariable logistic regression were used to assess differences in women who were teens at time of conception who had partner support during their pregnancy and those who did not, and their birth outcomes. RESULTS Even after controlling for potential confounding factors, women with a supportive partner were 63% less likely to experience LBW [aOR: 0.37, 95% CI: (0.26-0.54)] and nearly 2 times less likely to have pregnancy loss [aOR: 0.48, 95% CI: (0.32-0.72)] compared to those with no partner support. CONCLUSIONS Having partner support or involvement during a teenager's pregnancy may reduce the likelihood of having a poor birth outcome.
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Affiliation(s)
- Monisha K Shah
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Rebekah E Gee
- Louisiana State University School of Public Health, New Orleans, LA; Louisiana State University School Medicine, Department of Obstetrics and Gynecology, New Orleans, LA
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
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Urhoj SK, Jespersen LN, Nissen M, Mortensen LH, Nybo Andersen AM. Advanced paternal age and mortality of offspring under 5 years of age: a register-based cohort study. Hum Reprod 2013; 29:343-50. [DOI: 10.1093/humrep/det399] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Doamekpor LA, Amutah NN, Ramos LJ. Fathers matter: the role of paternal age in infant mortality. Am J Mens Health 2013; 8:175-82. [PMID: 24262789 DOI: 10.1177/1557988313511492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Infant mortality is the most widely used indicator of a nation's health status and is associated with a plethora of maternal and socioeconomic factors. Although the association between young and old maternal age and the risk of infant mortality is well established, the link between paternal age and birth outcomes has received far less attention. This study seeks to examine the added impact of paternal age on infant mortality, above and beyond that of maternal age among married couples. Using the 2002 linked birth and infant death data set (N = 63,754), hazard odds ratios for the association between combined adolescent and adult maternal and paternal age and the risk of infant mortality were estimated. Maternal demographic characteristics, such as education and race/ethnicity were controlled. The findings indicate that, independent of maternal education and race/ethnicity, adolescent father adds additional risk, above and beyond that of maternal age, only when the mother is older (21-45 years; hazard ratio = 2.7). This study highlights that for married couples, adolescent fathers add to the risk of infant mortality when the mothers are older, providing insight into the role of paternal age in infant mortality. Implications for additional research are discussed.
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Kovac JR, Addai J, Smith RP, Coward RM, Lamb DJ, Lipshultz LI. The effects of advanced paternal age on fertility. Asian J Androl 2013; 15:723-8. [PMID: 23912310 PMCID: PMC3854059 DOI: 10.1038/aja.2013.92] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 05/14/2013] [Accepted: 06/23/2013] [Indexed: 12/29/2022] Open
Abstract
Modern societal pressures and expectations over the past several decades have resulted in the tendency for couples to delay conception. While women experience a notable decrease in oocyte production in their late thirties, the effect of age on spermatogenesis is less well described. While there are no known limits to the age at which men can father children, the effects of advanced paternal age are incompletely understood. This review summarizes the current state of knowledge regarding advanced paternal age and its implications on semen quality, reproductive success and offspring health. This review will serve as a guide to physicians in counseling men about the decision to delay paternity and the risks involved with conception later in life.
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Oliveira EAD, Bertoldi AD, Domingues MR, Santos IS, Barros AJD. Factors associated to medicine use among children from the 2004 Pelotas Birth Cohort (Brazil). Rev Saude Publica 2013; 46:487-96. [PMID: 22635037 DOI: 10.1590/s0034-89102012000300011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 08/01/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify factors associated to medicine use among children from the 2004 Pelotas Birth Cohort, Brazil. METHODS Prospective study to evaluate medicine use in children aged 3, 12 and 24 months regardless of the reasons, therapeutic indication or class. The study included 3,985 children followed up at three months of age, 3,907 at 12 months, and 3,868 at the last follow-up time of 24 months. Mothers were interviewed to collect information on medicine use during the recall period of 15 days prior to the interview. The outcome was studied according to sociodemographic and perinatal variables, mother's perception of child's health and breastfeeding status. Crude and adjusted analyses were performed by Poisson regression following a hierarchical model. RESULTS The prevalence of medicine use ranged from 55% to 65% in the three follow-ups. After controlling for confounders, some variables remained associated to medicine use only at the three-month follow-up with greatest use among children of younger mothers, those children who had intrapartum complications, low birthweight, were never breastfed and were admitted to a hospital. Greatest medicine use was also associated with being a firstborn child at 3 and 12 months; mother's perception of their child health as fair or poor and children whose mothers have private health insurance at 12 and 24 months; highest maternal education level at all follow-up times. CONCLUSIONS Different variables influence medicine use among children during the first two years of life and they change as the child ages especially maternal factors and those associated to the child's health problems.
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Affiliation(s)
- Edilson Almeida de Oliveira
- Programa de Pós-Graduação em Saúde Coletiva. Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
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Nilsen ABV, Waldenström U, Rasmussen S, Hjelmstedt A, Schytt E. Characteristics of first-time fathers of advanced age: a Norwegian population-based study. BMC Pregnancy Childbirth 2013; 13:29. [PMID: 23363654 PMCID: PMC3566934 DOI: 10.1186/1471-2393-13-29] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 01/24/2013] [Indexed: 01/02/2023] Open
Abstract
Background The modern phenomenon of delayed parenthood applies not only to women but also to men, but less is known about what characterises men who are expecting their first child at an advanced age. This study investigates the sociodemographic characteristics, health behaviour, health problems, social relationships and timing of pregnancy in older first-time fathers. Methods A cross-sectional study was conducted of 14 832 men who were expecting their first child, based on data from the Norwegian Mother and Child Cohort Study (MoBa) carried out by the Norwegian Institute of Public Health. Data were collected in 2005–2008 by means of a questionnaire in gestational week 17–18 of their partner’s pregnancy, and from the Norwegian Medical Birth Register. The distribution of background variables was investigated across the age span of 25 years and above. Men of advanced age (35–39 years) and very advanced age (40 years or more) were compared with men aged 25–34 years by means of bivariate and multivariate logistic regression analyses. Results The following factors were found to be associated with having the first child at an advanced or very advanced age: being unmarried or non-cohabitant, negative health behaviour (overweight, obesity, smoking, frequent alcohol intake), physical and mental health problems (lower back pain, cardiovascular diseases, high blood pressure, sleeping problems, previous depressive symptoms), few social contacts and dissatisfaction with partner relationship. There were mixed associations for socioeconomic status: several proxy measures of high socioeconomic status (e.g. income >65 000 €, self-employment) were associated with having the first child at an advanced or very advanced age, as were several other proxy measures of low socioeconomic status (e.g. unemployment, low level of education, immigrant background).The odds of the child being conceived after in vitro fertilisation were threefold in men aged 34–39 and fourfold from 40 years and above. Conclusions Men who expect their first baby at an advanced or very advanced age constitute a socioeconomically heterogeneous group with more health problems and more risky health behaviour than younger men. Since older men often have their first child with a woman of advanced age, in whom similar characteristics have been reported, their combined risk of adverse perinatal outcomes needs further attention by clinicians and researchers.
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Alio AP, Salihu HM, McIntosh C, August EM, Weldeselasse H, Sanchez E, Mbah AK. The effect of paternal age on fetal birth outcomes. Am J Mens Health 2012; 6:427-35. [PMID: 22564913 DOI: 10.1177/1557988312440718] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Research investigating the role of paternal age in adverse birth outcomes is limited. This population-based retrospective cohort study used the Missouri maternally linked data set from 1989 to 2005 to assess whether paternal age affects fetal birth outcomes: low birth weight (LBW), preterm birth (PTB), stillbirth, and small size for gestational age (SGA). We examined these outcomes among infants across seven paternal age-groups (<20, 20-24, 25-29, 30-34, 35-39, 40-45, and >45 years) using the generalized estimating equation framework. Compared with infants born to younger fathers (25-29 years), infants born to fathers aged 40 to 45 years had a 24% increased risk of stillbirth but a reduced risk of SGA. A 48% increased risk of late stillbirth was observed in infants born to advanced paternal age (>45 years). Moreover, advanced paternal age (>45 years) was observed to result in a 19%, 13%, and 29% greater risk for LBW, PTB, and VPTB (very preterm birth) infants, respectively. Infants born to fathers aged 30 to 39 years had a lower risk of LBW, PTB, and SGA, whereas those born to fathers aged 24 years or younger had an elevated likelihood of experiencing these same adverse outcomes. These findings demonstrate that paternal age influences birth outcomes and warrants further investigation.
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Paternal age effect mutations and selfish spermatogonial selection: causes and consequences for human disease. Am J Hum Genet 2012; 90:175-200. [PMID: 22325359 DOI: 10.1016/j.ajhg.2011.12.017] [Citation(s) in RCA: 247] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 12/05/2011] [Accepted: 12/26/2011] [Indexed: 12/25/2022] Open
Abstract
Advanced paternal age has been associated with an increased risk for spontaneous congenital disorders and common complex diseases (such as some cancers, schizophrenia, and autism), but the mechanisms that mediate this effect have been poorly understood. A small group of disorders, including Apert syndrome (caused by FGFR2 mutations), achondroplasia, and thanatophoric dysplasia (FGFR3), and Costello syndrome (HRAS), which we collectively term "paternal age effect" (PAE) disorders, provides a good model to study the biological and molecular basis of this phenomenon. Recent evidence from direct quantification of PAE mutations in sperm and testes suggests that the common factor in the paternal age effect lies in the dysregulation of spermatogonial cell behavior, an effect mediated molecularly through the growth factor receptor-RAS signal transduction pathway. The data show that PAE mutations, although arising rarely, are positively selected and expand clonally in normal testes through a process akin to oncogenesis. This clonal expansion, which is likely to take place in the testes of all men, leads to the relative enrichment of mutant sperm over time-explaining the observed paternal age effect associated with these disorders-and in rare cases to the formation of testicular tumors. As regulation of RAS and other mediators of cellular proliferation and survival is important in many different biological contexts, for example during tumorigenesis, organ homeostasis and neurogenesis, the consequences of selfish mutations that hijack this process within the testis are likely to extend far beyond congenital skeletal disorders to include complex diseases, such as neurocognitive disorders and cancer predisposition.
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