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Parental age and preterm birth: a population-based cohort of nearly 3 million California livebirths from 2007 to 2012

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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Fig. 1: Distribution of paternal age categories (percentage) stratified on maternal age.
Fig. 2: Unadjusted (gray) and adjusted (black) hazard ratios and 95% confidence intervals for spontaneous and medically indicated preterm birth according to maternal or paternal.

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References

  1. Mathews TJ, Hamilton BE. First births to older women continue to rise. NCHS data brief, no 152. Hyattsville, MD: National Center for Health Statistics. 2014.

  2. Khandwala YS, Zhang CA, Lu Y, Eisenberg ML. The age of fathers in the USA is rising: an analysis of 168 867 480 births from 1972 to 2015. Hum Reprod. 2017;32:2110–6.

  3. Organisation for Economic Co-operation and Development. SF2.3: Age of mothers at childbirth and age-specific fertility. 29 May 2019. http://www.oecd.org/els/soc/SF_2_3_Age_mothers_childbirth.pdf. Accessed 22 October 2019.

  4. The American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and The Practice Committee of the American Society for Reproductive Medicine. Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril. 2014;101:633–4.

  5. Liu KE, Case A. No. 346—advanced reproductive age and fertility. J Obstet Gynaecol Can. 2017;39:685–95.

    Article  PubMed  Google Scholar 

  6. Johnson SL, Dunleavy J, Gemmell NJ, Nakagawa S. Consistent age-dependent declines in human semen quality: a systematic review and meta-analysis. Ageing Res Rev. 2015;19:22–33.

    Article  PubMed  Google Scholar 

  7. Kong A, Frigge ML, Masson G, Besenbacher S, Sulem P, Magnusson G, et al. Rate of de novo mutations and the importance of father’s age to disease risk. Nature. 2012;488:471–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Li J, Oehlert J, Snyder M, Stevenson DK, Shaw GM. Fetal de novo mutations and preterm birth. PLoS Genet. 2017;13:e1006689.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. Ford WC, North K, Taylor H, Farrow A, Hull MG, Golding J. Increasing paternal age is associated with delayed conception in a large population of fertile couples: evidence for declining fecundity in older men. The ALSPAC Study Team (Avon Longitudinal Study of Pregnancy and Childhood). Hum Reprod. 2000;15:1703–8.

    Article  CAS  PubMed  Google Scholar 

  10. Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M. Maternal age and fetal loss: population based register linkage study. Bmj. 2000;320:1708–12.

    Article  CAS  PubMed  Google Scholar 

  11. Nguyen BT, Chang EJ, Bendikson KA. Advanced paternal age and the risk of spontaneous abortion: an analysis of the combined 2011-2013 and 2013-2015 National Survey of Family Growth. Am J Obstet Gynecol. 2019;221:476.e1–e7.

    Article  Google Scholar 

  12. de la Rochebrochard E, Thonneau P. Paternal age and maternal age are risk factors for miscarriage; results of a multicentre European study. Hum Reprod. 2002;17:1649–56.

    Article  PubMed  Google Scholar 

  13. Kleinhaus K, Perrin M, Friedlander Y, Paltiel O, Malaspina D, Harlap S. Paternal age and spontaneous abortion. Obstet Gynecol. 2006;108:369–77.

    Article  CAS  PubMed  Google Scholar 

  14. Mayo JA, Lu Y, Stevenson DK, Shaw GM, Eisenberg ML. Parental age and stillbirth: a population-based cohort of nearly 10 million California deliveries from 1991 to 2011. Ann Epidemiol. 2019;31:32–7.e2.

    Article  PubMed  Google Scholar 

  15. Schummers L, Hutcheon JA, Hacker MR, VanderWeele TJ, Williams PL, McElrath TF, et al. Absolute risks of obstetric outcomes by maternal age at first birth: a population-based cohort. Epidemiology. 2018;29:379–87.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Urhoj SK, Andersen PK, Mortensen LH, Davey Smith G, Nybo, Andersen AM. Advanced paternal age and stillbirth rate: a nationwide register-based cohort study of 944,031 pregnancies in Denmark. Eur J Epidemiol. 2017;32:227–34.

    Article  PubMed  Google Scholar 

  17. Schempf AH, Branum AM, Lukacs SL, Schoendorf KC. Maternal age and parity-associated risks of preterm birth: differences by race/ethnicity. Paediatr Perinat Epidemiol. 2007;21:34–43.

    Article  PubMed  Google Scholar 

  18. Kenny LC, Lavender T, McNamee R, O’Neill SM, Mills T, Khashan AS. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PLoS ONE. 2013;8:e56583.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Alio AP, Salihu HM, McIntosh C, August EM, Weldeselasse H, Sanchez E, et al. The effect of paternal age on fetal birth outcomes. Am J Mens Health. 2012;6:427–35.

    Article  PubMed  Google Scholar 

  21. Astolfi P, De Pasquale A, Zonta LA. Paternal age and preterm birth in Italy, 1990 to 1998. Epidemiology. 2006;17:218–21.

    Article  PubMed  Google Scholar 

  22. Zhu JL, Madsen KM, Vestergaard M, Basso O, Olsen J. Paternal age and preterm birth. Epidemiology. 2005;16:259–62.

    Article  PubMed  Google Scholar 

  23. Chen XK, Wen SW, Krewski D, Fleming N, Yang Q, Walker MC. Paternal age and adverse birth outcomes: teenager or 40+, who is at risk? Hum Reprod. 2008;23:1290–6.

    Article  PubMed  Google Scholar 

  24. Basso O, Wilcox AJ. Paternal age and delivery before 32 weeks. Epidemiology. 2006;17:475–8.

    Article  PubMed  Google Scholar 

  25. Tough SC, Faber AJ, Svenson LW, Johnston DW. Is paternal age associated with an increased risk of low birthweight, preterm delivery, and multiple birth? Can J Public Health. 2003;94:88–92.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Abel EL, Kruger M, Burd L. Effects of maternal and paternal age on Caucasian and Native American preterm births and birth weights. Am J Perinatol. 2002;19:49–54.

    Article  PubMed  Google Scholar 

  27. Hurley EG, DeFranco EA. Influence of paternal age on perinatal outcomes. Am J Obstet Gynecol. 2017;217:566.e1–6.

    Article  Google Scholar 

  28. Sheen JJ, Wright JD, Goffman D, Kern-Goldberger AR, Booker W, Siddiq Z, et al. Maternal age and risk for adverse outcomes. Am J Obstet Gynecol. 2018;219:390.e1–5.

    Article  Google Scholar 

  29. Wikstrom AK, Gunnarsdottir J, Cnattingius S. The paternal role in pre-eclampsia and giving birth to a small for gestational age infant; a population-based cohort study. BMJ Open. 2012;2:e001178.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Harlap S, Paltiel O, Deutsch L, Knaanie A, Masalha S, Tiram E, et al. Paternal age and preeclampsia. Epidemiology. 2002;13:660–7.

    Article  PubMed  Google Scholar 

  31. Getahun D, Ananth CV, Vintzileos AM. Uteroplacental bleeding disorders during pregnancy: do missing paternal characteristics influence risk? BMC Pregnancy Childbirth. 2006;6:2.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Li DK, Wi S. Changing paternity and the risk of preeclampsia/eclampsia in the subsequent pregnancy. Am J Epidemiol. 2000;151:57–62.

    Article  CAS  PubMed  Google Scholar 

  33. Sharma R, Agarwal A, Rohra VK, Assidi M, Abu-Elmagd M, Turki RF. Effects of increased paternal age on sperm quality, reproductive outcome and associated epigenetic risks to offspring. Reprod Biol Endocrinol. 2015;13:35.

    Article  PubMed  PubMed Central  Google Scholar 

  34. The American Society for Reproductive Medicine. Guidelines for sperm donation. Fertil Steril. 2004;82 (Suppl 1):S9–12.

  35. Herrchen B, Gould JB, Nesbitt TS. Vital statistics linked birth/infant death and hospital discharge record linkage for epidemiological studies. Comput Biomed Res. 1997;30:290–305.

    Article  CAS  PubMed  Google Scholar 

  36. American College of Obstetricians and Gynecologists. Practice Bulletin No. 130. Obstet Gynecol. 2012;120:964–73.

  37. Harrell FE. Regression modeling strategies with applications to linear models, logistic regression, and survival analysis. New York, NY: Springer; 2001.

  38. Olshan AF, Ananth CV, Savitz DA. Intrauterine growth retardation as an endpoint in mutation epidemiology: an evaluation based on paternal age. Mutat Res. 1995;344:89–94.

    Article  CAS  PubMed  Google Scholar 

  39. Tan H, Wen SW, Walker M, Demissie K. Missing paternal demographics: a novel indicator for identifying high risk population of adverse pregnancy outcomes. BMC Pregnancy Childbirth. 2004;4:21.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Frederiksen LE, Ernst A, Brix N, Braskhoj Lauridsen LL, Roos L, Ramlau-Hansen CH, et al. Risk of adverse pregnancy outcomes at advanced maternal age. Obstet Gynecol. 2018;131:457–63.

    Article  PubMed  Google Scholar 

  41. Balayla J, Azoulay L, Assayag J, Benjamin A, Abenhaim HA. Effect of maternal age on the risk of stillbirth: a population-based cohort study on 37 million births in the United States. Am J Perinatol. 2011;28:643–50.

    Article  PubMed  Google Scholar 

  42. Waldenstrom U, Cnattingius S, Norman M, Schytt E. Advanced maternal age and stillbirth risk in nulliparous and parous women. Obstet Gynecol. 2015;126:355–62.

    Article  PubMed  Google Scholar 

  43. Blomberg M, Birch Tyrberg R, Kjolhede P. Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study. BMJ Open. 2014;4:e005840.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Lamminpaa R, Vehvilainen-Julkunen K, Gissler M, Heinonen S. Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997-2008. BMC Pregnancy Childbirth. 2012;12:47.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Keiser AM, Salinas YD, DeWan AT, Hawley NL, Donohue PK, Strobino DM. Risks of preterm birth among non-Hispanic black and non-Hispanic white women: Effect modification by maternal age. Paediatr Perinat Epidemiol. 2019;33:346–56.

    Article  PubMed  PubMed Central  Google Scholar 

  46. American College of Obstetricians and Gynecologists. Committee Opinion #671. Obstet Gynecol. 2016;128:e61–8.

  47. Li DK. Changing paternity and the risk of preterm delivery in the subsequent pregnancy. Epidemiology. 1999;10:148–52.

    Article  CAS  PubMed  Google Scholar 

  48. Bandoli G, Lindsay S, Johnson DL, Kao K, Luo Y, Chambers CD. Change in paternity and select perinatal outcomes: causal or confounded? J Obstet Gynaecol. 2012;32:657–62.

    Article  CAS  PubMed  Google Scholar 

  49. Vatten LJ, Skjaerven R. Effects on pregnancy outcome of changing partner between first two births: prospective population study. Bmj. 2003;327:1138.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Centola GM, Blanchard A, Demick J, Li S, Eisenberg ML. Decline in sperm count and motility in young adult men from 2003 to 2013: observations from a U.S. sperm bank. Andrology. 2016;4:270–6.

    Article  CAS  PubMed  Google Scholar 

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Funding

This work was supported by the March of Dimes Prematurity Research Center at Stanford University (MOD PR625253).

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Correspondence to Jonathan A. Mayo.

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Mayo, J.A., Lu, Y., Stevenson, D.K. et al. Parental age and preterm birth: a population-based cohort of nearly 3 million California livebirths from 2007 to 2012. J Perinatol 41, 2156–2164 (2021). https://doi.org/10.1038/s41372-020-00894-7

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