Disentangling the roles of maternal and paternal age on birth prevalence of down syndrome and other chromosomal disorders using a Bayesian modeling approach
Disentangling the roles of maternal and paternal age on birth prevalence of down syndrome and other chromosomal disorders using a Bayesian modeling approach
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DOI：
10.1186/s12874-019-0720-1
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发表时间：
2019-04-23
影响因子：
4
通讯作者：
Thompson, James A.
中科院分区：
文献类型：
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作者：
Thompson, James A.
背景：多种新生儿和儿科疾病与父亲年龄较大有关。将这些发现与许多男性晚育的证据结合起来，引起了相当大的公共卫生关注。父亲年龄的风险很难估计和解释，因为孩子的父母往往年龄相似，很可能混淆。流行病学研究通常使用回归模型来模拟父亲年龄的条件影响，这些模型通常将母亲年龄视为线性、曲线或年龄范围类别。每种方法都有其局限性。作为替代方案，目前的研究测量年龄到最近的一年，并拟合贝叶斯模型，其中每个父母的年龄都有一个条件自回归先验（CAR）。方法从美国Natality数据库中获取2014 - 2016年约1200万份出生记录数据。将年龄在15-49岁之间的母亲和年龄在15-65岁之间的父亲的数据交叉制成表格。使用条件自回归先验对母亲和父亲年龄分别和联合建模唐氏综合症和除唐氏综合症以外的染色体疾病的贝叶斯逻辑模型实施。结果在CAR先验条件下，采用父、母年龄的模型拟合效果优于传统模型。对于唐氏综合症，该方法将很大的风险归因于母亲年龄的增加，而父亲年龄的增加对出生患病率的影响很小。除唐氏综合症外，母亲的年龄也与出生时染色体疾病的患病率有关，而父亲的年龄则无关。结论父亲年龄的增加与唐氏综合症或除唐氏综合症以外的染色体疾病的风险增加无关。
BackgroundMultiple neonatal and pediatric disorders have been linked to older paternal ages. Combining these findings with the evidence that many men are having children at much later ages generates considerable public health concern. The risk of paternal age has been difficult to estimate and interpret because children often have parents whose ages are similar and likely to be confounded. Epidemiologic studies often model the conditional effects of paternal age using regression models that typically treat maternal age as linear, curvilinear or as age-band categories. Each of these approaches has limitations. As an alternative, the current study measures age to the nearest year, and fits a Bayesian model in which each parent's age is given a conditional autoregressive prior (CAR).MethodsData containing approximately 12,000,000 birth records were obtained from the United States Natality database for the years 2014 to 2016. Date were cross-tabulated for maternal ages 15-49years and for paternal ages 15-65years. A Bayesian logistic model was implemented using conditional autoregressive priors for both maternal and paternal ages modeled separately and jointly for both Down syndrome and chromosomal disorders other than Down syndrome.ResultsModels with maternal and paternal ages given CAR priors were judged to be better fitting than traditional models. For Down syndrome, the approach attributed a very large risk to advancing maternal age with the effect of advancing paternal age having a very small sparing effect on birth prevalence. Maternal age was also related to the birth prevalence of chromosomal disorders other than Down syndrome while paternal age was not.ConclusionsAdvancing paternal age was not associated with an increase in risk for either Down syndrome or chromosomal disorders other than Down syndrome.