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Hum. Reprod. Advance Access originally published online on February 6, 2008
Human Reproduction 2008 23(6):1290-1296; doi:10.1093/humrep/dem403
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© The Author 2008. 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 adverse birth outcomes: teenager or 40+, who is at risk?

Xi-Kuan Chen1,2,3, Shi Wu Wen1,2,4,7, Daniel Krewski3,4,5, Nathalie Fleming6, Qiuying Yang1,2 and Mark C. Walker1,2,4

1 OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, 501 Smyth Rd, Box 241, Ottawa, Ontario, Canada K1H 8L6 2 OMNI Research Group, Clinical Epidemiology Program, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada 3 McLaughlin Center for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada 4 Faculty of Medicine, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada 5 Risk Sciences International, Ottawa, Ontario, Canada 6 Pediatric Adolescent Gynecology, Children’s Hospital of East Ontario, University of Ottawa, Ontario, Canada

7 Correspondence address. E-mail: swwen{at}ohri.ca

BACKGROUND: Most previous studies on the effect of paternal age have focused on the association of advanced paternal age with congenital anomalies. The objective of this study was to determine whether paternal age is associated with the risk of adverse birth outcomes, independent of maternal confounders.

METHODS: We carried out a retrospective cohort study of 2 614 966 live singletons born to married, nulliparous women aged 20–29 years between 1995 and 2000 in the USA. Multiple logistic regressions were applied to estimate the independent effect of paternal age on adverse birth outcomes.

RESULTS: Compared with infants born to fathers aged 20–29 years, infants fathered by teenagers (<20 years old) had an increased risk of preterm birth [odds ratio (OR) = 1.15, 95% confidence interval (CI): 1.10, 1.20], low birth weight (OR = 1.13, 95% CI: 1.08, 1.19), small-for-gestational-age births (OR = 1.17, 95% CI: 1.13, 1.22), low Apgar score (OR = 1.13, 95% CI: 1.01, 1.27), neonatal mortality (OR = 1.22, 95% CI: 1.01, 1.49) and post-neonatal mortality (OR = 1.41, 95% CI: 1.09, 1.82). Advanced paternal age (≥40 years) was not associated with the risk of adverse birth outcomes.

CONCLUSIONS: Teenage fathers carry an increased risk of adverse birth outcomes that is independent of maternal confounders, whereas advanced paternal age is not an independent risk factor for adverse birth outcomes.

Key words: paternal age/preterm birth/low birth weight/small for gestational age birth/infant mortality

Submitted on September 11, 2007; resubmitted on November 5, 2007; accepted on November 14, 2007.


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