目的 分析父方年龄对妊娠结局的影响。 方法 选取2011年1月至2020年12月于南山区分娩且父方年龄有记录的产妇185104例,母方年龄、民族、受教育程度校正后,使用logistic regression analysis、generalized linear model分析父方高龄与妊娠不良结局的关系。 结果 父方年龄15~85岁,中位数31岁(四分位差,27~34岁),母方年龄14~51岁,中位数29岁(四分位差,26~32岁)。未经校正的分析显示,父方40~49岁组和≥50岁组妊娠期并发症发生率较高;父方<40岁组妊娠期并发症发生率较低。校正母方年龄和其他危险因素之后,父方年龄的增长与胎儿结构畸形、子痫前期、子痫、妊娠糖尿病、胎盘早剥、产后出血(≥500 mL)、早产、胎膜早破、死胎发病率的显著增加没有关系。 结论 校正分析结果提示,父方年龄对不良妊娠结局无独立影响,观察到的父方年龄的影响主要归因于母方年龄。
Abstract
Objective To analyze the effect of paternal age on pregnancy outcome. Methods A total of 185,104 women who delivered in Nanshan District between January 2011 and December 2020. The paternal age were recorded. Logistic regression analysis and generalized linear regression model was used to analyze the association between paternal advanced age and adverse pregnancy outcomes after adjustment for maternal age, ethnicity, and education. Results (1) Paternal age ranged from 15 to 85 years with a median of 31 years (interquartile difference, 27 to 34 years) and maternal age ranged from 14 to 51 years with a median of 29 years (interquartile difference, 26 to 32 years) . (2) In unadjusted analyses, the higher rates of pregnancy complications occurred in the paternal age group of 40~49 years and ≥50 years, and the lower rates of unadjusted pregnancy complications occurred in the paternal age group of <40 years. (3) After adjusted maternal age and other risk factors, increasing paternal age did not appear to be associated with increased incidence of structural abnormalities, preeclampsia, eclampsia, gestational diabetes, placental abruption, postpartum hemorrhage (≥500 ml) , preterm birth, premature rupture of membranes and stillbirth. Conclusions Results adjusted for maternal age indicated that paternal age had no significant effect on adverse pregnancy outcomes. The maternal age mainly contributed to the observed effect of paternal age.
关键词
父方年龄 /
  /
  /
妊娠结局 /
  /
  /
结构畸形
Key words
Paternal age /
  /
  /
  /
Pregnancy outcome /
  /
  /
  /
Structural malformation
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Javier, García-Ferreyra, Daniel, et al. High aneuploidy rates observed in embryos derived from donated oocytes are related to male aging and high percentages of sperm dna fragmentation[J]. Clin Med Insights Reprod Health, 2015, 9: 21-27. DOI: 10.4137/CMRH.S32769.
[2] Sharma R, Agarwal A, Rohra VK , et al. Effects of increased paternal age on sperm quality, reproductive outcome and associated epigenetic risks to offspring[J]. Reprod Biol Endocrinol, 2015, 13(1): 35-54. DOI: 10.1186/s12958-015-0028-x.
[3] Kleinhaus K, Perrin M, Friedlander Y, et al. Paternal age and spontaneous abortion[J]. Obstet Gynecol, 2006, 108(2): 369-377. DOI: 10.1093/aje/163.suppl_11.S56-d.
[4] Ramasamy R, Chiba K, Butler P, et al. Male biological clock: a critical analysis of advanced paternal age[J]. Fertil Steril, 2015, 103(6): 1402-1406. DOI: 10.1016/j.fertnstert.2015.03.011.
[5] Green RF, Devine O, Crider KS, et al. Association of paternal age and risk for major congenital anomalies from the national birth defects prevention study, 1997 to 2004[J]. Ann Epidemiol, 2010, 20(3): 241-249. DOI: 10.1016/j.annepidem.2009.10.009.
[6] Emily G, Hurley MD a, Emily A, et al. Influence of paternal age on perinatal outcomes[J]. Am J Obstetr Gynecol, 2017, 217(5). DOI: 10.1016/j.ajog.2017.07.034.
[7] Chen XK, Wen SW, Daniel K, et al. Paternal age and adverse birth outcomes: teenager or 40+, who is at risk[J]? Hum Reprod, 2008(6): 1290-1296. DOI: 10.1093/humrep/dem403.
[8] Dviri M, Madjunkova S, Koziarz A, et al. Is there an association between paternal age and aneuploidy? Evidence from young donor oocyte-derived embryos: a systematic review and individual patient data meta-analysis[J]. Hum Reprod Update, 2021, 27(3): 486-500. DOI: 10.1093/humupd/dmaa052.
[9] Carrasquillo RJ, Kohn TP, Cinnioglu C, et al. Advanced paternal age does not affect embryo aneuploidy following blastocyst biopsy in egg donor cycles[J]. J Assist Reprod Genet, 2019, 36(10): 2039-2045. DOI: 10.1007/s10815-019-01549-z.
[10]Dviri M, Madjunkova S, Koziarz A, et al. Is there a correlation between paternal age and aneuploidy rate? An analysis of 3,118 embryos derived from young egg donors[J]. Fertil Steril, 2020, 114(2): 293-300. DOI: 10.1016/j.fertnstert.2020.03.034.
[11]Stern JE, Luke B, MD Hornstein, et al. The effect of father's age in fertile, subfertile, and assisted reproductive technology pregnancies: a population based cohort study[J]. J Assist Reprod Genet, 2014, 31(11): 1437-1444. DOI: 10.1007/s10815-014-0327-8.
[12]Crane E, Morris JK. Paternal age and birth defects: how strong is the association.[J]. Hum Reprod, 2007, 22(8): 2349-2350. DOI: 10.1093/humrep/dem134.
基金
深圳市南山区卫生科技项目(20200095),广东省医学科学技术研究基金项目(C2022120)