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Yin S, Zhou Y, Zhao C, Yang J, Yuan P, Zhao Y, Qi H, Wei Y. Association of Paternal Age Alone and Combined with Maternal Age with Perinatal Outcomes: A Prospective Multicenter Cohort Study in China. J Epidemiol Glob Health 2024; 14:120-130. [PMID: 38190051 PMCID: PMC11043302 DOI: 10.1007/s44197-023-00175-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024] Open
Abstract
Maternal and paternal age at birth is increasing globally. Maternal age may affect perinatal outcomes, but the effect of paternal age and its joint effect with maternal age are not well established. This prospective, multicenter, cohort analysis used data from the University Hospital Advanced Age Pregnant Cohort Study in China from 2016 to 2021, to investigate the separate association of paternal age and joint association of paternal and maternal age with adverse perinatal outcomes. Of 16,114 singleton deliveries, mean paternal and maternal age (± SD) was 38.0 ± 5.3 years and 36.0 ± 4.1 years. In unadjusted analyses, older paternal age was associated with increased risks of gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy, preeclampsia, placenta accreta spectrum disorders, placenta previa, cesarean delivery (CD), and postpartum hemorrhage, preterm birth (PTB), large-for-gestational-age, macrosomia, and congenital anomaly, except for small-for-gestational-age. In multivariable analyses, the associations turned to null for most outcomes, and attenuated but still significant for GDM, CD, PTB, and macrosomia. As compare to paternal age of < 30 years, the risks in older paternal age groups increased by 31-45% for GDM, 17-33% for CD, 32-36% for PTB, and 28-31% for macrosomia. The predicted probabilities of GDM, placenta previa, and CD increased rapidly with paternal age up to thresholds of 36.4-40.3 years, and then plateaued or decelerated. The risks of GDM, CD, and PTB were much greater for pregnancies with younger paternal and older maternal age, despite no statistical interaction between the associations related to paternal and maternal age. Our findings support the advocation that paternal age, besides maternal age, should be considered during preconception counseling.Trial Registration NCT03220750, Registered July 18, 2017-Retrospectively registered, https://classic.clinicaltrials.gov/ct2/show/NCT03220750 .
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Affiliation(s)
- Shaohua Yin
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecology, National Center for Healthcare Quality Management in Obstetrics, Peking University Third Hospital, Haidian District, 49 North Garden Rd., Beijing, 100191, China
- National Clinical Research Center for Obstetrical and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Yubo Zhou
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, 100191, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Cheng Zhao
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecology, National Center for Healthcare Quality Management in Obstetrics, Peking University Third Hospital, Haidian District, 49 North Garden Rd., Beijing, 100191, China
- National Clinical Research Center for Obstetrical and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Jing Yang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecology, National Center for Healthcare Quality Management in Obstetrics, Peking University Third Hospital, Haidian District, 49 North Garden Rd., Beijing, 100191, China
- National Clinical Research Center for Obstetrical and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Pengbo Yuan
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecology, National Center for Healthcare Quality Management in Obstetrics, Peking University Third Hospital, Haidian District, 49 North Garden Rd., Beijing, 100191, China
- National Clinical Research Center for Obstetrical and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Yangyu Zhao
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecology, National Center for Healthcare Quality Management in Obstetrics, Peking University Third Hospital, Haidian District, 49 North Garden Rd., Beijing, 100191, China
- National Clinical Research Center for Obstetrical and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Hongbo Qi
- Department of Obstetrics, Women and Children's Hospital of Chongqing Medical University, No. 120 Longshan Road, Yubei District, Chongqing, 400021, China.
| | - Yuan Wei
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecology, National Center for Healthcare Quality Management in Obstetrics, Peking University Third Hospital, Haidian District, 49 North Garden Rd., Beijing, 100191, China.
- National Clinical Research Center for Obstetrical and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
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