Prevalence and risk factors for adult paternity among adolescent females ages 14 through 16 years

The association between parental age differences and perinatal outcomes

STUDY QUESTION

Are there significant associations existing between parental age differences and adverse perinatal outcomes?

SUMMARY ANSWER

Large differences in parental age are associated with adverse perinatal outcomes, particularly with older mothers paired with younger fathers.

WHAT IS KNOWN ALREADY

The association between advanced maternal age and perinatal outcomes is well-documented with women over 35 years showing an increased risk of several adverse outcomes. Other studies have identified potential associations between advanced paternal age and adverse perinatal outcomes.

STUDY DESIGN, SIZE, DURATION

A historical (retrospective) cohort analysis was performed utilizing a multivariable logistic regression model to evaluate the association between varying differences in parental age and adverse perinatal outcomes while controlling for demographic and health-related covariates. Data were compiled from the National Vital Statistics System for 20 613 704 births between 2012 and 2018.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Parental age differences, categorized into eleven 4-year intervals, were stratified by seven maternal age categories and evaluated for their associations with adverse perinatal outcomes. Main outcome measures included low birth weight, very low birth weight, preterm birth, very preterm birth, small size for gestational age, low 5-min appearance, pulse, grimace, activity, and respiration score, congenital defects, and chromosomal anomalies.

MAIN RESULTS AND THE ROLE OF CHANCE

Increased parental age differences, in either direction, were associated with significant risks for all adverse outcomes, aside from congenital defects, even when controlling for maternal age. Restricting maternal age to the reference range of 25-29 years, infants born to fathers aged 9-12 years younger (n = 3773) had 27% (odds ratio (OR) 1.27, 95% CI, 1.17-1.37) higher odds of having any adverse perinatal outcome. Infants born to fathers aged >16 years older (n = 98 555) had 14% (OR 1.14, 95% CI, 1.12-1.16) higher odds of having any adverse perinatal outcome.

LIMITATIONS, REASONS FOR CAUTION

Data extracted from US birth certificates may be compromised by errors in reporting or documentation. Information regarding the mother's socioeconomic status was estimated using proxy variables and may be susceptible to uncontrolled factors. Use of a pre-compiled dataset may potentially exclude additional maternal comorbidities that could impact perinatal outcomes.

WIDER IMPLICATIONS OF FINDINGS

Older mothers paired with younger fathers demonstrated the highest risk, even when maternal age was below the threshold of 35 years. For the clinical setting, parental age differences should be considered alongside maternal and paternal age when assessing risks of adverse perinatal outcomes for potential parents. This is particularly relevant for older women with younger male partners as this may exacerbate the impact of advanced maternal age.

STUDY FUNDING/COMPETING INTEREST(S)

This research was funded by the NIH Research Fellowship T35 Training Grant. There are no competing interests.

TRIAL REGISTRATION NUMBER

N/A.

Factors Associated With Being Pleased With a Female Partner Pregnancy Among Sexually Active U.S. Adolescent Males

Adolescent pregnancy remains a major U.S. public health problem. Little is known about pregnancy attitudes in U.S. adolescent males. The study objective was to identify factors from different domains that are associated with sexually active U.S. adolescent males who would be pleased with a female partner pregnancy (hereafter known as pleased with a pregnancy). The National Survey of Family Growth is a nationally representative survey of those 15 to 44 years old. Bivariate and multivariable analyses were performed of the 2002 and 2006-2010 cycles to examine factors associated with being pleased with a pregnancy among sexually active U.S. males. Among the 1,445 sexually active U.S. adolescent males surveyed, 25% would be pleased with a pregnancy. In bivariate analyses, ever being suspended from school, having sporadic health insurance, age, and ever HIV tested were significantly associated with being pleased with a pregnancy. In final multivariable analyses, sporadic insurance was associated with almost triple the odds, and being older and ever HIV tested with double the odds of being pleased with a pregnancy. Higher educational attainment for both adolescent males and adolescent males' fathers was associated with reduced odds of a being pleased with a pregnancy. One quarter of sexually active U.S. adolescent males would be pleased with a pregnancy. Adolescent males who have been sporadically insured, are older, and ever HIV tested have higher odds of being pleased with a pregnancy. Targeting these adolescent males for more focused pregnancy-prevention counseling may prove useful in reducing adolescent pregnancy rates.