The Effects of Parent Ages on Birth Defects.
The Effects of Parent Ages on Birth Defects.
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DOI：
10.31080/aspe.2020.03.0312
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发表时间：
2020-10
期刊：
影响因子：
--
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
在美国，男人和女人生孩子的年龄要大得多。这种不断变化的人口结构与目前被认为构成重大公共卫生危机的多个新生儿不良分娩结局有关。这项研究的目的是评估父母年龄对出生缺陷的风险，并提供可以作为更具体的中介模型的起点的结果。该模型估计了父母年龄对控制母亲和父亲年龄之间的混淆的出生缺陷的影响，并分离了包括唐氏综合症在内的染色体疾病的中介作用。从美国国籍数据库中获得了2014至2018年的数据，其中包含大约15,000,000个出生记录。贝叶斯建模方法被用来估计父母年龄的调整风险，包括未调整和调整的父母年龄，以及包括唐氏综合症在内的染色体疾病的中介效应。母亲年龄的增加与尿道下裂和紫红色先天性心脏病的风险增加有关。母亲和父亲年龄的增加与腹裂风险的降低有关。对于肢体缩小畸形、唇裂和所有畸形，母体年龄的风险是U型的，在大约35岁时观察到最低的风险。父亲的年龄与出生缺陷发生率的增加无关。产妇年龄的增加与先天性心脏病的出生发生率增加有关，与腹裂的出生发生率较低有关。年龄较大和较年轻的产妇都与肢体缩小、畸形和唇裂有关。父亲年龄的增加与出生缺陷发生率的增加无关，但与腹裂的出生发生率降低有关。
Men and women, in the United States, are having children at considerably older ages. This changing demographic has been associated with multiple neonatal adverse birth outcomes that are currently considered to constitute a major public health crisis. The objective of this study was to evaluate the risk of parent age on birth defects and to provide results that can serve as a starting point for more specific mediation modeling. The modeling estimated the effects of parent age on birth defects controlling for confounding between maternal and paternal age and separated the mediating effect of chromosomal disorders, including Down syndrome. 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 adjusted risks of parent ages both unadjusted and adjusted for the other parent’s age and for the mediational effect of chromosomal disorders, including Down syndrome. Increasing maternal age was associated with increased risks for hypospadias and cyanotic congenital heart disease. Increasing maternal and paternal ages were associated with decreasing risks for gastroschisis. For limb reduction defect, cleft lip and all defects combined, the risk of maternal age was U-shaped with the lowest risks observed at approximately age 35y. Paternal age was not associated with an increase in the birth prevalence of birth defects. Advancing maternal age was associated with increased birth prevalence of hypospadias and cyanotic congenital heart disease and associated with a lower birth prevalence for gastroschisis. Both older and younger maternal ages were related to limb reduction defect and cleft lip. Advancing paternal age was not associated with an increased birth prevalence of birth defects but was associated with a decreased birth prevalence of gastroschisis.