The risks of advancing parental age on neonatal morbidity and mortality are U- or J-shaped for both maternal and paternal ages.
The risks of advancing parental age on neonatal morbidity and mortality are U- or J-shaped for both maternal and paternal ages.
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DOI：
10.1186/s12887-020-02341-0
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发表时间：
2020-09-28
期刊：
影响因子：
2.4
通讯作者：
Thompson JA
中科院分区：
文献类型：
--
作者：
Thompson JA
延迟生育的生物学影响被归咎于美国的重大公共卫生危机，包括新生儿发病率和死亡率（NMM）高。本研究的目的是评估父母年龄对NMM的风险，并提供可以作为更具体的中介建模起点的结果。从2014年至2018年的美国出生率数据库中获得了包含约15，000，000份出生记录的数据。贝叶斯建模方法用于估计总效应和调整父母年龄之间的混杂因素和包括唐氏综合征在内的染色体疾病的介导的风险。结果包括院内死亡和新生儿发病率的9项措施。对于父亲年龄，7例NMM（早产，极早产，低Apgar评分，抗生素治疗，表面活性剂治疗，长时间通气，院内死亡）具有U形风险模式，2例NMM（小于胎龄，新生儿重症监护）具有J形风险模式，1例NMM（癫痫发作）与父亲年龄无显著相关性。对于产妇年龄，三个NMM（Apgar评分低、抗生素治疗和院内死亡）呈U形风险模式，4例NMM（早产，极早产，新生儿重症监护室入院，表面活性剂治疗）具有J形风险模式，1例NMM（小于胎龄）的风险随着年龄的增长而下降，1例NMM（长时间通气）的风险随年龄增加而增加，1例NMM（癫痫发作）与母亲年龄无显著相关性。母亲和父亲年龄的增加都有新生儿发病率和死亡率的U形或J形风险模式。
The biologic implications of delayed parenthood have been blamed for a major public health crisis in the United States, that includes high rates of neonatal morbidity and mortality (NMM). The objective of this study was to evaluate the risk of parent age on NMM and to provide results that can serve as a starting point for more specific mediation modeling. Data containing approximately 15,000,000 birth records were obtained from the United States Natality database for the years 2014 to 2018. A Bayesian modeling approach was used to estimate the both the total effect and the risk adjusted for confounding between parent ages and for mediation by chromosomal disorders including Down syndrome. Outcomes included intra-hospital death and nine measures of neonatal morbidity. For paternal age, seven NMM (preterm birth, very preterm birth, low Apgar score, treatment with antibiotics, treatment with surfactant, prolonged ventilation, intra-hospital death) had U-shaped risk patterns, two NMM (small for gestational age, admission to neonatal intensive care) had J-shaped risk patterns, one NMM (seizures) was not significantly related to paternal age. For maternal age, three NMM (low Apgar score, treatment with antibiotics and intra-hospital death) had U-shaped risk patterns, four NMM (preterm delivery, very preterm delivery, admission to neonatal intensive care, treatment with surfactant) had J-shaped risk patterns, one NMM (small for gestational age) had a risk declining with age, one NMM (prolonged ventilation) had a risk increasing with age and one NMM (seizures) was not significantly related to maternal age. Both advancing maternal and paternal ages had U- or J-shaped risk patterns for neonatal morbidity and mortality.
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DOI：
10.1080/10705511.2017.1342541
发表时间：
2018
期刊：
Structural equation modeling : a multidisciplinary journal
影响因子：
--
作者：
Miočević M;Gonzalez O;Valente MJ;MacKinnon DP
通讯作者：
MacKinnon DP
影响因子：
2.5
作者：
Neels K;Murphy M;Ní Bhrolcháin M;Beaujouan É
通讯作者：
Beaujouan É
DOI：
10.1111/rssa.12520
发表时间：
2019-09-26
影响因子：
2
作者：
Bijlsma, Maarten J.;Wilson, Ben
通讯作者：
Wilson, Ben
影响因子：
7
作者：
Pearl, Judea
通讯作者：
Pearl, Judea
影响因子：
4
作者：
Thompson, James A.
通讯作者：
Thompson, James A.