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Hum. Reprod. Advance Access originally published online on December 12, 2006
Human Reproduction 2007 22(3):696-701; doi:10.1093/humrep/del453
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Paternal age and birth defects: how strong is the association?

Q. Yang1,2,5, S.W. Wen1,2,4, A. Leader3, X.K. Chen1,2, J. Lipson2 and M. Walker1,2

1 OMNI Research Group, Ottawa Hospital Research Institute, Ottawa, Canada 2 Division of Maternal and Fetal Medicine 3 Division of Reproductive Medicine and Department of Obstetrics and Gynecology 4 Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada

5 To whom correspondence should be addressed at: OMNI Research Group, Department of Obstetrics and Gynecology, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 241, Ottawa, Canada K1H 8L6. Tel: +1 613 737 8899 ext. 73046; Fax: +1 613 737 8781; E-mail: qyang{at}ohri.ca

BACKGROUND: Although the association between maternal age and the risks of birth defects has been well studied, the evidence from population data linking paternal age with birth defects was limited and inconsistent.

METHODS: We conducted a population-based retrospective cohort study of 5 213 248 subjects from the 1999–2000 birth registration data of the USA. Multiple logistic regressions were used to estimate the independent effect of paternal age on all birth defects and 21 specific defects groups after adjusting for potential confounding of maternal age, race, education, marital status, parity, prenatal care initiation, maternal smoking and alcohol drinking during pregnancy.

RESULTS: A total of 77 514 (1.5%) birth defects were recorded in the study cohort. The adjusted odds ratios were 1.04 (1.01, 1.06), 1.08 (1.04, 1.12), 1.08 (1.02, 1.14) and 1.15 (1.06, 1.24), respectively, for infants born to fathers 30–35, 40–44, 45–49 and over 50 years (test for trend, P = 0.0155), when compared with those infants born to fathers aged 25–29 for any birth defect. Advanced paternal age was associated with increased risks of heart defects, tracheo-oesophageal fistulaoesophageal atresia, other musculoskeletal/integumental anomalies, Down's syndrome and other chromosomal anomalies. Fathers under 25 years of age were also at increased risks of spina bifida/meningocele, microcephalus, omphalocele/gastroschisis and other musculoskeletal/integumental anomalies.

CONCLUSIONS: Infants born to older fathers have a slightly increased risk of birth defects. Young paternal age is also associated with slightly increased risk of several selected birth defects in their offspring. However, given the weak association, paternal age appears to play a small role in the aetiology of birth defects.

Key words: birth defects/maternal age/paternal age/risk

Submitted on July 7, 2006; resubmitted on October 12, 2006; accepted on October 19, 2006.


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