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Wang SH, Lin MC, Wu CS, Chen PC, Thompson WK, Fan CC. Familial factors rather than paternal age contribute to the aetiology of epilepsy. Int J Epidemiol 2024; 53:dyad191. [PMID: 38199793 DOI: 10.1093/ije/dyad191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Whether paternal age associated with offspring's epilepsy risk is a cause of de novo mutation as men age, or just an association due to confounding factors, is still unclear. METHODS We performed a population-based, multi-generation and sibling comparison study in Taiwan, which included 2 751 232 singletons born in 2001-17 who were followed until 2020. Of these, 819 371/826 087 with information on paternal/maternal grandparents were selected for multi-generation analyses and 1 748 382 with sibling(s) were selected for sibling comparison. Cox proportional hazard regression was used to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS In the total cohort, there was an increased risk of epilepsy in individuals with advanced paternal age, e.g. the HR for paternal age ≥50 was1.36 (95% CI: 1.15-1.61) compared with paternal age 25-29, and fathers older than mothers, e.g. the HR for parental age difference ≥15 years was 1.29 (95% CI: 1.16-1.43). When accounting for parental age difference, the association between paternal age and epilepsy in offspring was attenuated (HR for paternal age ≥50 was 1.11, 95% CI: 0.93-1.34). Multi-generation analyses did not support the association of advanced grand-paternal age at childbirth of the parent with offspring's risk of epilepsy. Sibling comparison analyses did not support the association of older paternal age with increased risk of epilepsy (HR was 0.96 for per year increase in paternal age, 95% CI: 0.96-0.97). CONCLUSIONS These results do not support the hypothesis that advanced paternal age is associated with epilepsy in offspring. Instead, familial factors may explain the observed paternal age association with the offspring's risk of epilepsy.
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Affiliation(s)
- Shi-Heng Wang
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Mei-Chen Lin
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Douliu, Taiwan
| | - Pei-Chun Chen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
| | - Wesley K Thompson
- Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Chun-Chieh Fan
- Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, OK, USA
- Department of Radiology, School of Medicine, University of California San Diego, La Jolla, CA, USA
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Wang SH, Wu CS, Hsu LY, Lin MC, Chen PC, Thompson WK, Fan CC. Paternal age and 13 psychiatric disorders in the offspring: a population-based cohort study of 7 million children in Taiwan. Mol Psychiatry 2022; 27:5244-5254. [PMID: 36042285 DOI: 10.1038/s41380-022-01753-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/02/2022] [Accepted: 08/12/2022] [Indexed: 01/14/2023]
Abstract
Although paternal age has been linked to certain psychiatric disorders, the nature of any causal relationship remains elusive. Here, we aimed to comprehensively assess the magnitude of a wide range of offspring's psychiatric risk conferred by paternal age, leveraging a pedigree inferred from covered-insurance relationship (accuracy >98%) in Taiwan's single-payer compulsory insurance program. We also examined whether there is an independent role of paternal age and explored the potential effect of parental age difference. A total cohort of 7,264,788 individuals born between 1980 and 2018 were included; 5,572,232 with sibling(s) were selected for sibling-comparison analyses and 1,368,942 and 1,044,420 children with information of paternal-grandparents and maternal-grandparents, respectively, were selected for multi-generation analyses. Using inpatient/outpatient claims data (1997-2018), we identified schizophrenia, autism, bipolar disorder (BPD), attention deficit-hyperactivity disorder (ADHD), major depressive disorder (MDD), eating disorder (ED), substance use disorder (SUD), mental retardation (MR), tic disorder, obsessive-compulsive disorder (OCD), anxiety, and somatoform disorder. We identified suicides using death certificates. Logistic regression analysis was used to estimate the paternal/maternal/grand-paternal age association with psychiatric risk in the offspring. The total cohort and sibling-comparison cohort resulted in similar estimates. Paternal age had a U-shaped relationship with offspring's MDD, ED, SUD, and anxiety. A very young maternal age (<20 years) was associated with markedly higher risk in offspring's SUD, MR, and suicide. Older paternal age (>25 years) was linearly associated with offspring's schizophrenia, autism, BPD, ADHD, MDD, ED, SUD, MR, OCD, anxiety, and suicide. Older grand-paternal age was linearly associated with offspring's schizophrenia, autism, ADHD, and MR. Dissimilar parental age was positively associated with offspring's ADHD, MDD, SUD, MR, anxiety, and suicide, and negatively associated with offspring's OCD. This comprehensive assessment provides solid evidence for the independent role of paternal age in psychiatric risk in the offspring and clarifies the significance of both early parenthood and delayed paternity.
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Affiliation(s)
- Shi-Heng Wang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan. .,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan. .,Interdisciplinary Freshmen Program of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Yunlin branch, Douliu, Taiwan
| | - Le-Yin Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Graduate Program of Data Science, National Taiwan University and Academia Sinica, Taipei, Taiwan
| | - Mei-Chen Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan.,Interdisciplinary Freshmen Program of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Pei-Chun Chen
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Wesley K Thompson
- Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Chun-Chieh Fan
- Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, OK, USA.,Department of Radiology, School of Medicine, University of California San Diego, La Jolla, CA, USA
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Zweifel JE, Woodward JT. The risky business of advanced paternal age: neurodevelopmental and psychosocial implications for children of older fathers. Fertil Steril 2022; 118:1013-1021. [PMID: 36347660 DOI: 10.1016/j.fertnstert.2022.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/08/2022]
Abstract
The last several decades are notable for an increase in the percentage of births attributable to men in their 40s and 50s. There is general recognition of offspring health risks related to advanced maternal age, however, fewer patients and providers are informed about the impacts of advanced paternal age (APA). This review examined the literature investigating the association between APA and offspring outcomes, specifically, neurodevelopmental, psychiatric, academic, and behavioral impairment, the impact of paternal health decline and death, and the influence of age on parenting behaviors. This analysis revealed that children, and even grandchildren, of older fathers face significantly increased incidence rates of psychiatric disease and behavioral impairment. The data do not show evidence of superior parenting behaviors among men with APA. Finally, children of men with APA are significantly more likely to experience early bereavement, which is associated with psychological and developmental consequences. An understanding of the degree to which APA can negatively impact the offspring is imperative for patient counseling and development of practice guidelines.
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Affiliation(s)
- Julianne E Zweifel
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - Julia T Woodward
- Department of Psychiatry and Behavioral Sciences, Duke Fertility Center, Duke University Health System, Durham, North Carolina, USA; Department of Obstetrics and Gynecology, Duke Fertility Center, Duke University Health System, Durham, North Carolina, USA
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Parental Age and the Risk of ADHD in Offspring: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094939. [PMID: 34066379 PMCID: PMC8124990 DOI: 10.3390/ijerph18094939] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 01/24/2023]
Abstract
Evidence has suggested that parental age at birth is a risk factor of offspring attention deficit/hyperactivity disorder (ADHD). We conducted a meta-analysis of observational studies investigating the association between parental age and offspring ADHD. We conducted a systematic search that followed the recommended guidelines for performing meta-analyses on PUBMED, EMBASE, and Web of Science up to 8 April 2021. We calculated pooled risk estimates from individual age with and without adjusting for possible confounding factors. Dose–response analysis for parental age and ADHD risk was performed. Eleven studies were selected in this meta-analysis, which included 111,101 cases and 4,417,148 participants. Compared with the reference points, the lowest parental age category was associated with an increased risk of ADHD in the offspring, with adjusted odds ratios (ORs) of 1.49 (95% confidence intervals (95%CI) 1.19–1.87) and 1.75 (95%CI 1.31–2.36) for the mother and father, respectively. The highest parental age was statistically insignificant, with adjusted ORs of 1.11 (95%CI 0.79–1.55) and 0.93 (95%CI 0.70–1.23) for mother and father separately. Dose–response analysis indicated a non-linear relationship of parental age with offspring ADHD, with the lowest ADHD risk at 31–35 years old. The results of this meta-analysis support an association between young parental age and the risk of ADHD. More high-quality studies are needed to establish whether the association with parental age is causal.
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