Can oxytocin augmentation modify the risk of epidural analgesia by maternal age in cesarean sections?

Advanced Paternal Age in Focus: Unraveling Its Influence on Assisted Reproductive Technology Outcomes

As global demographics shift toward increasing paternal age, the realm of assisted reproductive technologies (ARTs), particularly in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), faces new challenges and opportunities. This study provides a comprehensive exploration of the implications of advanced paternal age on ART outcomes. Background research highlights the social, cultural, and economic factors driving men toward later fatherhood, with a focus on the impact of delayed paternity on reproductive outcomes. Methods involve a thorough review of existing literature, centering on changes in testicular function, semen quality, and genetic and epigenetic shifts associated with advancing age. Study results point to intricate associations between the father's age and ART outcomes, with older age being linked to diminished semen quality, potential genetic risks, and varied impacts on embryo quality, implantation rates, and birth outcomes. The conclusions drawn from the current study suggest that while advanced paternal age presents certain risks and challenges, understanding and mitigating these through strategies such as sperm cryopreservation, lifestyle modifications, and preimplantation genetic testing can optimize ART outcomes. Future research directions are identified to further comprehend the epigenetic mechanisms and long-term effects of the older father on offspring health. This study underscores the need for a comprehensive approach in navigating the intricacies of delayed fatherhood within the context of ART, aiming for the best possible outcomes for couples and their children.

Interaction between delivery mode and maternal age in predicting overweight and obesity in 1,123 Chinese preschool children

Background

Pediatric overweight/obesity has escalated to epidemic proportions worldwide. In this study, we aimed to assess the association of delivery mode and maternal age, both individually and interactively, with the risk of being overweight or obese among Chinese preschool children.

Methods

We cross-sectionally recruited 1,123 preschool children from five kindergartens in Beijing. Data were collected by a pre-validated self-developed questionnaire. Overweight and obesity are defined according to the World Health Organization (WHO), International Obesity Task Force (IOTF), and China criteria, respectively.

Results

Cesarean delivery was significantly associated with pediatric overweight/obesity under the WHO [adjusted odds ratio (aOR), 95% confidence interval (CI): 1.60, 1.12-2.29], IOTF (1.77, 1.23-2.53), and China (1.43, 1.06-1.94) criteria, respectively. Maternal age <28 years reached statistical significance under both WHO (1.69, 1.09-2.61) and IOTF (1.69, 1.09-2.61) criteria in predicting pediatric overweight/obesity. The interaction between cesarean delivery and maternal age <28 years was remarkably significant under the WHO (2.26, 1.10-4.67), IOTF (2.92, 1.43-5.96), and China (2.36, 1.24-4.50) criteria.

Conclusions

Our findings indicate that the interaction between cesarean delivery and maternal age <28 years can remarkably increase the risk of overweight/obesity among Chinese preschool children.

Maternal age and risk of cesarean section in women with induced labor at term-A Nordic register-based study

INTRODUCTION

Over the last decades, induction of labor has increased in many countries along with increasing maternal age. We assessed the effects of maternal age and labor induction on cesarean section at term among nulliparous and multiparous women without previous cesarean section.

MATERIAL AND METHODS

We performed a retrospective national registry-based study from Denmark, Finland, Iceland, Norway, and Sweden including 3 398 586 deliveries between 2000 and 2011. We investigated the impact of age on cesarean section among 196 220 nulliparous and 188 158 multiparous women whose labor was induced, had single cephalic presentation at term, and no previous cesarean section. Confounders comprised country, time-period, and gestational age.

RESULTS

In nulliparous women with induced labor the rate of cesarean section increased from 14.0% in women less than 20 years of age to 39.9% in women 40 years and older. Compared with women aged 25-29 years, the corresponding relative risks were 0.60 (95% confidence interval [95% CI] 0.57 to 0.64) and 1.72 (95% CI 1.66 to 1.79). In multiparous induced women the risk of cesarean section was 3.9% in women less than 20 years rising to 9.1% in women 40 years and older. Compared with women aged 25-29 years, the relative risks were 0.86 (95% CI 0.54 to 1.37) and 1.98 (95% CI 1.84 to 2.12), respectively. There were minimal confounding effects of country, time-period, and gestational age on risk for cesarean section.

CONCLUSIONS

Advanced maternal age is associated with increased risk of cesarean section in women undergoing labor induction with a single cephalic presentation at term without a previous cesarean section. The absolute risk of cesarean section is 3-5 times higher across 5-year age groups in nulliparous relative to multiparous women having induced labor.