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Kop P, van Wely M, de Melker A, van der Veen F, Mochtar M. Donor sperm treatment: the role of semen parameters in intracervical insemination, a retrospective cohort study. HUM FERTIL 2023; 26:964-970. [PMID: 35114884 DOI: 10.1080/14647273.2022.2032407] [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: 01/17/2021] [Accepted: 11/18/2021] [Indexed: 11/04/2022]
Abstract
Donor sperm treatment is advised to be performed with frozen-thawed donor semen. A disadvantage of frozen-thawed semen is lower pregnancy rates compared to inseminations with fresh semen. Semen parameters affect ongoing pregnancy rates in intracervical inseminations with frozen-thawed donor semen. In an attempt to translate this into clinical relevance, cohort studies have tried to find cut-off values for semen parameters after thawing for intracervical insemination, but these studies assessed only one semen parameter per study, thereby overlooking the intricate interplay between all semen parameters. We performed a retrospective cohort study and tried to calculate thresholds for all semen parameters that lead to the best possible ongoing pregnancy rates in intracervical insemination with frozen-thawed donor semen. Between April 1999 and December 2015, data from 1,186 women who underwent 7,103 cycles of intracervical insemination with donor semen from 129 sperm donors were available for analysis. Our results showed that total motility and total motile count (TMC) after thawing were associated with ongoing pregnancy rate. The best possible ongoing pregnancy chances after intracervical insemination were obtained at a total motility of ≥20% and a total motile count (TMC) of ≥8 × 106 after thawing.
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Affiliation(s)
- Petronella Kop
- Center for Reproductive Medicine, Amsterdam Reproduction and Development Institute, Amsterdam UMC, AMC, Amsterdam, Netherlands
| | - Madelon van Wely
- Center for Reproductive Medicine, Amsterdam Reproduction and Development Institute, Amsterdam UMC, AMC, Amsterdam, Netherlands
| | - Annemieke de Melker
- Center for Reproductive Medicine, Amsterdam Reproduction and Development Institute, Amsterdam UMC, AMC, Amsterdam, Netherlands
| | - Fulco van der Veen
- Center for Reproductive Medicine, Amsterdam Reproduction and Development Institute, Amsterdam UMC, AMC, Amsterdam, Netherlands
| | - Monique Mochtar
- Center for Reproductive Medicine, Amsterdam Reproduction and Development Institute, Amsterdam UMC, AMC, Amsterdam, Netherlands
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Gili JA, Rittler M, Heisecke S, Campaña H, Giménez L, Santos MR, Ratowiecki J, Cosentino V, López Camelo J, Poletta FA. Paternal age and risk for selected birth defects in a large South American sample. Birth Defects Res 2023; 115:1866-1875. [PMID: 37728171 DOI: 10.1002/bdr2.2252] [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: 04/03/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND The relationship between maternal age (MA) and birth defects (BD) has been extensively studied while much less research, mostly with discordant results, has focused on the risk of paternal age (PA) for BD. Furthermore, no consensus has been reached on the best way to control the association of PA with MA. OBJECTIVES The aim of the study was to evaluate the risk of PA increase, at 1-year intervals, for selected BD, especially controlling for the confounding effect of MA. METHODS The sample comprised of 27,944 liveborns presenting 1 of 18 selected isolated BD. Conditional logistic regressions were applied to evaluate the risk of advanced PA and its yearly increase, adjusting by MA and other variables. RESULTS Of the 18 analyzed BD, only the risk for preaxial polydactyly (PreP) showed a significant association with increasing PA, while advanced MA was of low risk. For esophageal and anal atresia, associations with both PA and MA increases were observed. CONCLUSIONS Results support the hypothesis of advanced PA as a risk factor for PreP and helps clarify the so far unexplained nonrandom association between this defect and Down syndrome.
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Affiliation(s)
- Juan A Gili
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Instituto Académico Pedagógico de Ciencias Humanas, Universidad Nacional de Villa María, Córdoba, Argentina
| | - Monica Rittler
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Hospital Materno Infantil Ramón Sardá, Buenos Aires, Argentina
| | - Silvina Heisecke
- Dirección de Investigación, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC- CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Hebe Campaña
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Comisión de Investigaciones Científicas (CICPBA), Buenos Aires, Argentina
| | - Lucas Giménez
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Instituto Nacional de Genética Médica Populacional (INAGEMP), CEMIC-CONICET, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - María Rita Santos
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Comisión de Investigaciones Científicas (CICPBA), Buenos Aires, Argentina
- Instituto Multidisciplinario de Biología Celular (IMBICE, CONICET-UNLP-CICPBA), Buenos Aires, Argentina
| | - Julia Ratowiecki
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Viviana Cosentino
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Hospital Interzonal General de Agudos Luisa C. de Gandulfo, Buenos Aires, Argentina
| | - Jorge López Camelo
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Instituto Nacional de Genética Médica Populacional (INAGEMP), CEMIC-CONICET, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Fernando A Poletta
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Instituto Nacional de Genética Médica Populacional (INAGEMP), CEMIC-CONICET, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
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Bu X, Ye W, Zhou J. Paternal age, risk of congenital anomalies, and birth outcomes: a population-based cohort study. Eur J Pediatr 2023; 182:3519-3526. [PMID: 37193751 DOI: 10.1007/s00431-023-05025-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/18/2023]
Abstract
The objective of the study was to explore the impact of paternal age on the risk of congenital anomalies and birth outcomes in infants born in the USA between 2016 and 2021. This retrospective cohort study used data from the National Vital Statistics System (NVSS) database, a data set containing information on live birth in the USA between 2016 and 2021. Newborns were divided into four groups based on their paternal age (< 25, 25-34, 35-44, and > 44 years) and using the 25-34 age group as a reference. The primary outcomes were congenital anomalies involving structural anomalies and chromosome anomalies. Secondary outcomes were preterm birth, low birth weight, severe neonatal perinatal asphyxia, and admission to neonatal intensive care units (NICU). A multivariable logistic regression model was used to analyze the association between paternal age and outcomes. Overall, 17,764,695 live births were included in the final analyses. After adjusting confounding factors, advanced paternal age > 44 years was associated with increased odds of congenital anomalies (adjusted odds ratio (aOR) = 1.17, 95%CI 1.12-1.21) compared with the 25-34 age group, mainly for the chromosomal anomalies (aOR = 1.59, 95%CI 1.40-1.78) but not the structure anomalies (aOR = 1.03, 95%CI 0.97-1.09). The risk of preterm delivery, low birth weight, and NICU hospitalization in their infants was increased by advanced parental age as well. Conclusion: Advanced paternal age increases the risk of congenital anomalies, especially chromosomal anomalies in their offspring, implying prenatal genetic counseling is required. What is Known: • There's a rising trend of advanced paternal age, which is associated with an increased likelihood of premature birth and low birth weight in their offspring. However, the exploration between paternal age and congenital abnormalities in offspring was limited and contradictory. What is New: • Infants with a paternal age > 44 years were more likely to be born with congenital anomalies, especially chromosomal anomalies.
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Affiliation(s)
- Xinghe Bu
- Department of Neonatology, National Children's Medical Center (Shanghai), Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, China
| | - Wenjing Ye
- Department of Neonatology, National Children's Medical Center (Shanghai), Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, China
| | - Jianguo Zhou
- Department of Neonatology, National Children's Medical Center (Shanghai), Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, China.
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4
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Zhang C, Yan L, Qiao J. Effect of advanced parental age on pregnancy outcome and offspring health. J Assist Reprod Genet 2022; 39:1969-1986. [PMID: 35925538 PMCID: PMC9474958 DOI: 10.1007/s10815-022-02533-w] [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: 06/22/2021] [Accepted: 11/24/2021] [Indexed: 10/16/2022] Open
Abstract
PURPOSE Fertility at advanced age has become increasingly common, but the aging of parents may adversely affect the maturation of gametes and the development of embryos, and therefore the effects of aging are likely to be transmitted to the next generation. This article reviewed the studies in this field in recent years. METHODS We searched the relevant literature in recent years with the keywords of "advanced maternal/paternal age" combined with "adverse pregnancy outcome" or "birth defect" in the PubMed database and classified the effects of parental advanced age on pregnancy outcomes and birth defects. Related studies on the effect of advanced age on birth defects were classified as chromosomal abnormalities, neurological and psychiatric disorders, and other systemic diseases. The effect of assisted reproduction technology (ART) on fertility in advanced age was also discussed. RESULTS Differences in the definition of the range of advanced age and other confounding factors among studies were excluded, most studies believed that advanced parental age would affect pregnancy outcomes and birth defects in offspring. CONCLUSION To some extent, advanced parental age caused adverse pregnancy outcomes and birth defects. The occurrence of these results was related to the molecular genetic changes caused by aging, such as gene mutations, epigenetic variations, etc. Any etiology of adverse pregnancy outcomes and birth defects related to aging might be more than one. The detrimental effect of advanced age can be corrected to some extent by ART.
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Affiliation(s)
- Cong Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49, North garden road, Haidian district, Beijing, 100191, People's Republic of China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest (Chinese Academy of Medical Sciences), Beijing, 100191, China
- Savid Medical College (University of Chinese Academy of Sciences), Beijing, 100049, China
| | - Liying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49, North garden road, Haidian district, Beijing, 100191, People's Republic of China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest (Chinese Academy of Medical Sciences), Beijing, 100191, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49, North garden road, Haidian district, Beijing, 100191, People's Republic of China.
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China.
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China.
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China.
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest (Chinese Academy of Medical Sciences), Beijing, 100191, China.
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Sudheer KR, Mohammad Koya PK, Prakash AJ, Prakash AM, Manoj Kumar R, Shyni S, Jagadeesan CK, Jaikrishan G, Das B. Evaluation of risk due to chronic low dose ionizing radiation exposure on the birth prevalence of congenital heart diseases (CHD) among the newborns from high-level natural radiation areas of Kerala coast, India. Genes Environ 2022; 44:1. [PMID: 34983691 PMCID: PMC8725549 DOI: 10.1186/s41021-021-00231-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023] Open
Abstract
Background The human population residing in monazite bearing Kerala coast are exposed to chronic low dose and low dose rate external gamma radiation due to Th232 deposits in its beach sand. The radiation level in this area varies from < 1.0 to 45.0 mGy/year. This area serves as an ideal source for conducting large-scale epidemiological studies for assessing risk of low dose and low dose rate radiation exposure on human population. The areas with a dose level of ≤1.50 mGy/year are considered as normal level natural radiation areas (NLNRAs) and areas with > 1.50 mGy/year, as high level natural radiation areas (HLNRAs). HLNRAs were further stratified into three dose groups of 1.51-3.0 mGy/year, 3.01-6.00 mGy/year and > 6.0 mGy/year. The present study evaluates the effects of chronic low dose radiation (LDR) exposure on the birth prevalence of Congenital Heart Diseases (CHD) among the live newborns monitored in hospital based prospective study from NLNRAs and HLNRAs of Kerala coast, India. Methodology Consecutive newborns were monitored from two hospital units located in the study area for congenital malformations. Referred CHD cases among the newborns screened were confirmed by conducting investigations such as pulse oximetry, chest X-ray, electrocardiogram and echocardiogram etc. Results Among the newborns screened, 289 CHDs were identified with a frequency of 1.49‰ among 193,634 livebirths, which constituted 6.03% of overall malformations and 16.29% of major malformations. Multiple logistic regression analysis suggested that the risk of CHD among the newborns of mothers from HLNRAs with a dose group of 1.51-3.0 mGy/year was significantly lower as compared to NLNRA (OR = 0.72, 95% CI: 0.57-0.92), whereas it was similar in HLNRA dose groups of 3.01-6.00 mGy/year (OR = 0.55, 95% CI: 0.31-1.00) and ≥ 6.0 mGy/year (OR = 0.96, 95% CI: 0.50-1.85). The frequency of CHDs did not show any radiation dose related increasing trend. However, a significant (P = 0.005) reduction was observed in the birth prevalence of CHDs among the newborns from HLNRA (1.28‰) as compared to NLNRA (1.79‰). Conclusion Chronic LDR exposure did not show any increased risk on the birth prevalence of CHDs from high-level natural radiation areas of Kerala coast, India. No linear increasing trend was observed with respect to different background dose groups. The frequency of CHD was observed to be 1.49 per 1000 livebirths, which was similar to the frequency of severe CHD rate reported elsewhere in India and was much less than the reported frequency of 9 per thousand.
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Affiliation(s)
- K R Sudheer
- Low Level Radiation Research Laboratory, Low Level Radiation Research Section (LLRRS), Radiation Biology & Health Sciences Division (RB&HSD), Bio-Science Group (BSG), Bhabha Atomic Research Centre (BARC), Beach Road, Kollam, Kerala, 691 001, India
| | - P K Mohammad Koya
- Low Level Radiation Research Laboratory, Low Level Radiation Research Section (LLRRS), Radiation Biology & Health Sciences Division (RB&HSD), Bio-Science Group (BSG), Bhabha Atomic Research Centre (BARC), Beach Road, Kollam, Kerala, 691 001, India
| | - Anu J Prakash
- Department of Paediatrics, Victoria Hospital, Kollam, 691 001, India
| | - Ambily M Prakash
- Department of Gynaecology, Victoria Hospital, Kollam, 691 001, India
| | - R Manoj Kumar
- Department of Paediatrics, Taluk Head Quarters Hospital, Karunagapally, 690 544, India
| | - S Shyni
- Department of Gynaecology, Taluk Head Quarters Hospital, Karunagapally, 690 544, India
| | - C K Jagadeesan
- Directorate of Health Services, Government of Kerala, Thiruvananthapuram, 695 011, India
| | - G Jaikrishan
- Low Level Radiation Research Laboratory, Low Level Radiation Research Section (LLRRS), Radiation Biology & Health Sciences Division (RB&HSD), Bio-Science Group (BSG), Bhabha Atomic Research Centre (BARC), Beach Road, Kollam, Kerala, 691 001, India
| | - Birajalaxmi Das
- Low Level Radiation Research Section (LLRRS), Homi Bhabha National Institute (HBNI), Radiation Biology & Health Sciences Division (RB&HSD), Bio-Science Group (BSG), Bhabha Atomic Research Centre (BARC), Mumbai, 400 085, India. .,Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400 094, India.
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Massarotti C, Uraji J, Ali ZE, Serdarogullari M, Makieva S, Liperis G, Kohlhepp F, Fraire-Zamora JJ, Ammar OF, Barratt C, Martins da Silva S, Mincheva M. #ESHREjc live edition report: 'the forgotten Y'-advanced paternal age from a global health perspective. Hum Reprod 2021; 37:195-197. [PMID: 34751767 DOI: 10.1093/humrep/deab241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Claudia Massarotti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI Dept.), University of Genoa, Genoa, Italy
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Julia Uraji
- IVF Laboratory, TFP Kinderwunschzentrum, Düsseldorf, Germany
| | | | - Munevver Serdarogullari
- Department of Histology and Embryology, Faculty of Medicine, Cyprus International University, Northern Cyprus via Mersin 10, Turkey
| | - Sofia Makieva
- Kinderwunschzentrum, Klinik für Reproduktions-Endokrinologie, Universitätsspital Zürich, Zurich, Switzerland
| | - George Liperis
- Westmead Fertility Centre, Institute of Reproductive Medicine, University of Sydney, Westmead, NSW, Australia
| | - Florian Kohlhepp
- Global Medical Affairs Fertility, Research and Development, Merck KGaA, Darmstadt, Germany
| | | | | | - Christopher Barratt
- Reproductive Medicine Research Group, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Sarah Martins da Silva
- Reproductive Medicine Research Group, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Mina Mincheva
- Centre for Tumour Microenvironment, Barts Cancer Institute, Queen Mary University of London, London, UK
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7
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Chen R, Chen L, Liu Y, Wang F, Wang S, Huang Y, Hu KL, Fan Y, Liu R, Zhang R, Zhang D. Association of parental prepregnancy BMI with neonatal outcomes and birth defect in fresh embryo transfer cycles: a retrospective cohort study. BMC Pregnancy Childbirth 2021; 21:793. [PMID: 34836492 PMCID: PMC8627045 DOI: 10.1186/s12884-021-04261-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/09/2021] [Indexed: 12/12/2022] Open
Abstract
Background Parental body mass index (BMI) is associated with pregnancy outcomes. But the effect of parental prepregnancy BMI on offspring conceived via in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), especially the birth defect, remains to be determined. This study aimed to investigate the associations of parental prepregnancy BMI with neonatal outcomes and birth defect in fresh embryo transfer cycles. Methods We conducted a retrospective cohort study including 5741 couples in their first fresh IVF/ICSI cycles admitted to Women’s Hospital, School of Medicine, Zhejiang University from January 2013 to July 2016. The primary outcome was birth defects, which was classified according to the International Classification of Diseases, 10th Revision. Secondary outcomes included preterm delivery rate, infant gender, birth weight, small-for-gestational age (SGA) and large-for-gestational age (LGA). Multilevel regression analyses were used to assess the associations of parental prepregnancy BMI with neonatal outcomes and birth defect. Results In singletons, couples with prepregnancy BMI ≥25 kg/m2 had higher odds of LGA than those with BMI < 25 kg/m2. The birth defect rate was significantly higher when paternal prepregnancy BMI ≥25 kg/m2 in IVF cycles (aOR 1.82, 95% CI 1.06–3.10) and maternal BMI ≥25 kg/m2 in ICSI cycles (aOR 4.89, 95% CI 1.45–16.53). For subcategories of birth defects, only the odds of congenital malformations of musculoskeletal system was significantly increased in IVF offspring with paternal BMI ≥25 kg/m2 (aOR 4.55, 95% CI 1.32–15.71). For twins, there was no significant difference among four groups, except for the lower birth weight of IVF female infants. Conclusions Parental prepregnancy BMI ≥25 kg/m2 is associated with higher incidence of LGA in IVF/ICSI singletons. Paternal prepregnancy BMI ≥25 kg/m2 was likely to have higher risk of birth defect in IVF offspring than those with BMI < 25 kg/m2, particularly in the musculoskeletal system. It is essential for overweight or obesity couples to lose weight before IVF/ICSI treatments. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04261-y.
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Affiliation(s)
- Ruixue Chen
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Lifen Chen
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Yifeng Liu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Feixia Wang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Siwen Wang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Yun Huang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Kai-Lun Hu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Yuzhi Fan
- School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Ruoyan Liu
- School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Runjv Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.,Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Dan Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China. .,School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China. .,Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.
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Kornerup N, Andersen AMN, Andersen PK, Bilsteen JF, Urhoj SK. Social, demographic and health characteristics of men fathering children at different ages. Sci Rep 2021; 11:21021. [PMID: 34697360 PMCID: PMC8545932 DOI: 10.1038/s41598-021-00482-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to examine associations between selected sociodemographic, socioeconomic, and health characteristics and the rates of fatherhood in different age groups. We investigated rates between 2011 and 2015 in a population-based register study including all men born from 1945 to 1995 residing in Denmark in 2011. The study population consisted of 1,867,108 men who fathered 268,612 children during the follow-up. The associations were quantified as incidence rate ratios using Poisson regression. Young men had higher rates of fathering a child if they lived outside the Capital Region, had a relatively high income, were previously diagnosed with cardiovascular disease, psychoactive substance abuse, personality disorders, schizophrenia or behavioural and emotional disorders. Men of advanced age had higher rates of fathering a child when born outside Denmark, living in the Capital Region, were in the lower or upper 10th percentile income group, were self-employed or unemployed or previously diagnosed with depression. Men of advanced age had lower rates of fathering a child if previously diagnosed with somatic diseases, psychoactive substance abuse or mental retardation. The findings highlight the importance of consideration of various sociodemographic, socioeconomic, and health characteristics when studying associations between paternal age and offspring health.
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Affiliation(s)
- Nina Kornerup
- Faculty of Health and Medical Sciences, Section of Epidemiology, University of Copenhagen, Øster Farimagsgade 5A, Box 2099, 1014, Copenhagen K, Denmark.
- Department of Gynecology and Obstetrics, Holbæk Hospital, Smedelundsgade 60, 4300, Holbæk, Denmark.
| | - Anne-Marie Nybo Andersen
- Faculty of Health and Medical Sciences, Section of Epidemiology, University of Copenhagen, Øster Farimagsgade 5A, Box 2099, 1014, Copenhagen K, Denmark
| | - Per Kragh Andersen
- Faculty of Health and Medical Sciences, Section of Biostatistics, University of Copenhagen, Øster Farimagsgade 5 opg. B, P.O. Box 2099, 1014, Copenhagen K, Denmark
| | - Josephine Funck Bilsteen
- Faculty of Health and Medical Sciences, Section of Epidemiology, University of Copenhagen, Øster Farimagsgade 5A, Box 2099, 1014, Copenhagen K, Denmark
| | - Stine Kjaer Urhoj
- Faculty of Health and Medical Sciences, Section of Epidemiology, University of Copenhagen, Øster Farimagsgade 5A, Box 2099, 1014, Copenhagen K, Denmark
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9
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Salazar-Reviakina A, Sierra-Bretón M, Rumbo J, Madariaga I, Tovar C, Uribe M, Sequera C, Rodríguez C, Holguín J, Sarmiento K, Hurtado-Villa P, Zarante I. Characterization of Risk Factors for Neural Tube Defects: A Case-Control Study in Bogota and Cali, Colombia, 2001-2018. J Child Neurol 2021; 36:509-516. [PMID: 33393845 DOI: 10.1177/0883073820981514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Worldwide prevalence of neural tube defects is between 1.2 and 124.1 per 10 000 live births. This study analyzes risk factors linked with neural tube defects. The study focused on the Surveillance and Monitoring Programs of Congenital Anomalies databases in Bogota and Cali. Births were monitored between 2001 and 2018. Liveborn or stillborn with neural tube defects were defined as cases, using a case-control ratio of 1:4. Paternal age, folic acid supplementation, birth weight, urban or rural origin, maternal and paternal studies, and socioeconomic levels were analyzed. Across the 215 730 births monitored, 147 cases with a rate of 6.82/10 000 live births were found (6.79-6.85). In isolated cases, lower birth weight had a P <.01. Paternal age >45 years showed an odds ratio (OR) of 4.24 (1.54-11.65), socioeconomic status 1 and 2, OR of 2.49 (1.63-3.82), maternal primary schooling or lower OR 2.61 (1.28-5.31), and housing in urban areas OR 2.4 (1.4-4.09).
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Affiliation(s)
| | | | - Jose Rumbo
- 27964Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Ithzayana Madariaga
- Institute of Human Genetics, 27964Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Catherin Tovar
- Institute of Human Genetics, 27964Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Mateo Uribe
- 27964Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | - Jorge Holguín
- Secretaría de Salud Pública de Cali, Valle del Cauca, Colombia
| | - Karen Sarmiento
- Department of Physiological Sciences, Faculty of Medicine, 27964Pontificia Universidad Javeriana, Barrientos. Bogotá, Colombia
| | - Paula Hurtado-Villa
- Department of Basic Sciences, Faculty of Health, 27964Pontificia Universidad Javeriana, Cali, Colombia
| | - Ignacio Zarante
- Institute of Human Genetics, 27964Pontificia Universidad Javeriana, Bogotá, Colombia.,Genetics Service, Hospital Universitario San Ignacio, Bogotá, Colombia
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10
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Schliep KC, Feldkamp ML, Hanson HA, Hollingshaus M, Fraser A, Smith KR, Panushka KA, Varner MW. Are paternal or grandmaternal age associated with higher probability of trisomy 21 in offspring? A population-based, matched case-control study, 1995-2015. Paediatr Perinat Epidemiol 2021; 35:281-291. [PMID: 33258505 PMCID: PMC8058293 DOI: 10.1111/ppe.12737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/21/2020] [Accepted: 09/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fetal aneuploidy risk increases with maternal age, but the majority of pregnancies complicated by trisomy 21 occur in younger women. It has been suggested that grandmaternal and/or paternal age may also play a role. OBJECTIVES To assess the association between grandmaternal and paternal age and trisomy 21. METHODS For the grandmaternal assessments, we included all offspring with trisomy 21 in a statewide birth defects surveillance system (1995-2015) that could be linked to 3-generation matrilineal pedigrees in the Utah Population Database. Ten sex/birth year-matched controls were selected for each case (770 cases and 7700 controls). For the paternal assessments, our cohort included all trisomy 21 cases (1995-2015) where both the mother and father resided in Utah at the time of birth (1409 cases and 14 090 controls). Ages were categorised by 5-year intervals (reference: 25-29 years). Conditional logistic regression, adjusting for potential confounding factors, was used to model the association between grandmaternal and paternal age and trisomy 21. RESULTS No association between grandmaternal age and trisomy 21 was detected, whether age was assessed continuously (adjusted odds ratio [OR] 1.01, 95% confidence interval [CI] 0.98, 1.03) or categorically after adjusting for grandmaternal and grandpaternal race/ethnicity and grandpaternal age. Compared to fathers aged 20-29 years, fathers <20 years (OR 3.15, 95% CI 1.99, 4.98) and 20-24 years (OR 1.39, 95% CI 1.11, 1.73) had increased odds of trisomy 21 offspring, after adjusting for maternal and paternal race/ethnicity and maternal age. Results were consistent after excluding stillbirths, multiples, and trisomy 21 due to translocation or mosaicism. CONCLUSIONS Maternal age is an important risk factor for trisomy 21 offspring; however, this population-based study shows that that young paternal age is also associated with trisomy 21, after taking into account maternal age and race/ethnicity.
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Affiliation(s)
- Karen C. Schliep
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Heidi A. Hanson
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
- Department of Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | - Alison Fraser
- Department of Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Ken R. Smith
- Department of Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - Katherine A. Panushka
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Michael W. Varner
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
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11
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Joinau-Zoulovits F, Bertille N, Cohen JF, Khoshnood B. Association between advanced paternal age and congenital heart defects: a systematic review and meta-analysis. Hum Reprod 2021; 35:2113. [PMID: 32730591 DOI: 10.1093/humrep/deaa105] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/18/2020] [Indexed: 01/06/2023] Open
Abstract
STUDY QUESTION Is there an association between advanced paternal age and congenital heart defects (CHD)? SUMMARY ANSWER Advanced paternal age is associated with a 16% increase in the overall odds of CHD. WHAT IS KNOWN ALREADY CHD are the most common congenital malformations. Several risk factors for CHD have been identified in the literature, but the association between advanced paternal age and CHD remains unclear. STUDY DESIGN, SIZE, DURATION We conducted a systematic literature search on MEDLINE and EMBASE (1960-2019) to identify studies assessing the association between advanced paternal age (≥35 years) and the risk of CHD, unrestrictive of language or sample size. We used a combination of Medical Subject Headings (MeSH) terms and free text words such as 'paternal age', 'paternal factors', 'father's age', 'parental age', 'heart', 'cardiac', 'cardiovascular', 'abnormalities, congenital', 'birth defects', 'congenital malformations' and 'congenital abnormalities'. PARTICIPANTS/MATERIALS, SETTING, METHODS We included observational studies aiming at assessing the association between paternal age and CHD. The included population could be live births, fetal deaths and terminations of pregnancy for fetal anomaly. To be included, studies had to provide either odds ratios (OR) with their 95% confidence interval (CI) or sufficient information to recalculate ORs with 95% CIs per paternal age category. We excluded studies if they had no comparative group and if they were reviews or case reports. Two independent reviewers selected the studies, extracted the data and assessed risk of bias using a modified Newcastle-Ottawa Scale. We used random-effects meta-analysis to produce summary estimates of crude OR. Associations were also tested in subgroups. MAIN RESULTS AND THE ROLE OF CHANCE Of 191 studies identified, we included nine studies in the meta-analysis (9 917 011 participants, including 34 447 CHD), including four population-based studies. Five studies were judged at low risk of bias. Only one population-based study specifically investigated isolated CHD. The risk of CHD was higher with advanced paternal age (summary OR 1.16, 95% CI, 1.07-1.25). Effect sizes were stable in population-based studies and in those with low risk of bias. LIMITATIONS AND REASONS FOR CAUTION The available evidence did not allow to assess (i) the risk of isolated CHD in population-based studies, (ii) the association between paternal age and the risk for specific CHD and (iii) the association between paternal age and CHD after adjustment for other risk factors, such as maternal age. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest that advanced paternal age may be a risk factor for CHD. However, because the association is modest in magnitude, its usefulness as a criterion for targeted screening for CHD seems limited. STUDY FUNDING/COMPETING INTEREST(S) None. PROSPERO REGISTRATION NUMBER CRD42019135061.
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Affiliation(s)
- F Joinau-Zoulovits
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, F-75004 Paris, France.,Department of Obstetrics and Gynecology, Centre hospitalier général de Saint-Denis, Saint-Denis, France
| | - N Bertille
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, F-75004 Paris, France
| | - J F Cohen
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, F-75004 Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, APHP, Paris Descartes University, Paris, France
| | - B Khoshnood
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, F-75004 Paris, France
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12
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Ţarcă E, Roșu ST, Cojocaru E, Trandafir L, Luca AC, Rusu D, Ţarcă V. Socio-Epidemiological Factors with Negative Impact on Infant Morbidity, Mortality Rates, and the Occurrence of Birth Defects. Healthcare (Basel) 2021; 9:healthcare9040384. [PMID: 33915730 PMCID: PMC8065913 DOI: 10.3390/healthcare9040384] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 12/16/2022] Open
Abstract
In the last 30-40 years, developed countries in particular, but also developing ones, have seen an increase in life expectancy and a decrease in infant mortality and morbidity rates. These factors are due to an increase in living standards, a decrease in differences between social classes, the increased accessibility of education to women, and the implementation of some public health measures. When certain basic social and medical measures are implemented on a large scale, their benefits are first reflected in lower infant mortality rates, and only in the second stage are such benefits reflected in decreasing neonatal mortality rates and a smaller number of stillbirths. In this study, we review the literature on these factors. We extrapolate and compare this literature with data recorded in our country in the hopes of finding the reasons why Romania ranks first in the European Union in terms of infant mortality rates. We found that lowering the infant morbidity, mortality, and congenital malformation rates is an absolute priority in Romania, which requires the involvement of decision makers in taking effective measures regarding food supplementation or enhancement using folic acid, adequate counselling of couples, monitoring of all pregnancies, setting antenatal diagnosis, implementing optimal delivery management and therapeutic approaches to problematic pregnancies in other hospitals and by involving the population in health education, avoiding occupational or in-home exposure to toxic factors, avoiding drug use, and implementing disease and infection prevention measures for pregnant women.
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Affiliation(s)
- Elena Ţarcă
- Department of Surgery II-Pediatric Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
- Correspondence: (E.Ţ.); (E.C.)
| | - Solange Tamara Roșu
- Department of Nursing, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania;
| | - Elena Cojocaru
- Department of Morphofunctional Sciences I—Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
- Correspondence: (E.Ţ.); (E.C.)
| | - Laura Trandafir
- Department of Mother and Child Medicine–Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (L.T.); (A.C.L.)
| | - Alina Costina Luca
- Department of Mother and Child Medicine–Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (L.T.); (A.C.L.)
| | - Daniela Rusu
- Department of Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania;
| | - Viorel Ţarcă
- County Statistics Department, 700115 Iaşi, Romania;
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13
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Hvide HK, Johnsen J, Salvanes KG. Parental age and birth defects: a sibling study. Eur J Epidemiol 2021; 36:849-860. [PMID: 33761052 PMCID: PMC8416834 DOI: 10.1007/s10654-021-00734-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Abstract
Higher parental age at childbearing has generated much attention as a potential risk factor for birth disorders; however, previous research findings are mixed. Existing studies have exploited variation in parental age across families, which is problematic because families differ not only in parental age but also in genetic and environmental factors. To isolate the effects of parental age, holding many genetic and environmental factors constant, we exploit the variation in parental age within families and compare outcomes for full siblings. The study data were retrieved from the Medical Birth Registry of Norway, which covers the entire population of births in Norway over an extended period (totaling 1.2 million births). Using variation in parental age when siblings were born, we find large and convex effects of increased parental age on the increased risk of birth disorders. To facilitate comparison with the existing literature, we also estimate the effects of parental age using variation in parental age across families and find that the effects are substantially weaker. We conclude that the existing literature may have underestimated the negative effects of parental aging on adverse offspring outcomes.
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Affiliation(s)
- Hans K Hvide
- University of Bergen, Bergen, Norway. .,CEPR, London, UK. .,University of Aberdeen, Aberdeen, UK.
| | | | - Kjell G Salvanes
- CEPR, London, UK.,FAIR, Bergen, Norway.,Norwegian School of Economics, Bergen, Norway.,IZA, Bergen, Norway.,HCEO, Bergen, Norway
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14
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Agot GN, Mweu MM, Wang'ombe JK. Risk factors for major external structural birth defects among children in Kiambu County, Kenya: a case-control study. F1000Res 2021; 10:59. [PMID: 33880173 PMCID: PMC8039862 DOI: 10.12688/f1000research.50738.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 01/24/2023] Open
Abstract
Background: Although major external structural birth defects continue to occur globally, the greatest burden is shouldered by resource-constrained countries with no surveillance systems. To our knowledge, many studies have been published on risk factors for major external structural birth defects, however, limited studies have been published in developing countries. The objective of this study was to identify risk factors for major external structural birth defects among children in Kiambu County, Kenya. Methods: A hospital-based case-control study was used to identify the risk factors for major external structural birth defects. A structured questionnaire was used to gather information retrospectively on maternal exposure to environmental teratogens, multifactorial inheritance, and sociodemographic-environmental factors during the study participants' last pregnancies. Descriptive analyses (means, standard deviations, medians, and ranges) were used to summarize continuous variables, whereas categorical variables were summarized as proportions and percentages in frequency tables. Afterward, logistic regression analyses were conducted to estimate the effects of the predictors on the odds of major external structural birth defects in the country. Results: Women who conceived when residing in Ruiru sub-county (adjusted odds ratio [aOR]: 5.28; 95% CI; 1.68-16.58; P<0.01), and Kiambu sub-county (aOR: 0.27; 95% CI; 0.076-0.95; P=0.04), and preceding siblings with history of birth defects (aOR: 7.65; 95% CI; 1.46-40.01; P=0.02) were identified as the significant predictors of major external structural birth defects in the county. Conclusions: These findings pointed to MESBDs of genetic, multifactorial inheritance, and sociodemographic-environmental etiology. Thus, we recommend regional defect-specific surveillance programs, public health preventive measures, and treatment strategies to understand the epidemiology and economic burden of these defects in Kenya. We specifically recommend the integration of clinical genetic services with routine reproductive health services because of potential maternal genetic predisposition in the region.
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Affiliation(s)
- George N Agot
- School of Public Health, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Marshal M Mweu
- School of Public Health, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Joseph K Wang'ombe
- School of Public Health, College of Health Sciences, University of Nairobi, Nairobi, Kenya
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15
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Montagnoli C, Ruggeri S, Cinelli G, Tozzi AE, Bovo C, Bortolus R, Zanconato G. Anything New about Paternal Contribution to Reproductive Outcomes? A Review of the Evidence. World J Mens Health 2021; 39:626-644. [PMID: 33474842 PMCID: PMC8443996 DOI: 10.5534/wjmh.200147] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/13/2020] [Accepted: 11/08/2020] [Indexed: 11/15/2022] Open
Abstract
Paternal health and behavioral lifestyles affect reproductive and neonatal outcomes and yet the magnitude of these effects remain underestimated. Even though these impacts have been formally recognized as a central aspect of reproductive health, health care services in Europe often neglect the involvement of fathers in their reproductive programs. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews, a literature search was carried out to assess the possible impact of paternal health on reproductive outcomes. The comprehensive strategy included cohort studies and meta-analysis available on PubMed, Web of Science, CINAHL, and Google scholar. Cross-referencing of bibliographies of the selected papers ensured wider study capture. Paternal factors were grouped into two categories respectively identified with the terms "Biological Paternal Factors" and "Lifestyle Paternal Factors". Advanced age may impair male fertility and affect early pregnancy stages. Increased body mass index, smoking, alcohol and recreational drugs, all alter seminal fluid parameters. Hazardous alcohol use correlates with low birthweight in pregnancy and harmful behavioral lifestyles have been linked to congenital heart defects, metabolic and neurodevelopmental disorders in the offspring. Measures targeting paternal health and lifestyle within the first 1,000 days' timeframe need to be implemented in couples undergoing reproductive decisions. Health professionals, as well as future fathers, must be aware of the benefits for the offspring associated with correct paternal behaviors. More research is needed to build guidelines and to implement specific programs aiming at reproductive health promotion.
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Affiliation(s)
- Caterina Montagnoli
- Department of Medical Direction, Verona University Hospital, Verona, Italy.,Department of Midwifery, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | | | - Giulia Cinelli
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto E Tozzi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Chiara Bovo
- Department of Medical Direction, Verona University Hospital, Verona, Italy
| | - Renata Bortolus
- Directorate General for Preventive Health - Office 9, Ministry of Health, Rome, Italy
| | - Giovanni Zanconato
- Department of Surgery, Odontostomatology and Maternal and Child Health, University of Verona, Verona, Italy
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16
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Xie D, Yang W, Fang J, Li H, Xiong L, Kong F, Wang A, Liu Z, Wang H. Chromosomal abnormality: Prevalence, prenatal diagnosis and associated anomalies based on a provincial-wide birth defects monitoring system. J Obstet Gynaecol Res 2020; 47:865-872. [PMID: 33372274 DOI: 10.1111/jog.14569] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/16/2020] [Accepted: 11/02/2020] [Indexed: 01/17/2023]
Abstract
AIM To investigate the epidemiology of chromosomal abnormalities (CA) in fetuses of all pregnancies based on a provincial-wide birth defects-monitoring system, which could provide scientific basis for making relatively policy and research. METHODS Chromosomal abnormalities cases were collected from all hospitals in Hunan Province, China, between 2016 and 2019. The prevalence of CAs was calculated to examine associations among infant sex, maternal age and region. The rates of prenatal diagnosis and termination of pregnancy (TOP) involving CA or associated anomalies were calculated as rates or proportions. RESULTS From 2016 to 2019, a total of 2 883 890 perinatal infants (28 weeks of gestation to postpartum 7 days) underwent prenatal screening and diagnostic tests, and 3181 fetuses were diagnosed as CA, with the prevalence of 11.03/10 000. The average prevalence of CAs was higher for male than female fetuses (11.33/10 000 vs 10.06/10 000) (OR = 1.13, 95% CI: 1.05-1.21), which was higher in urban areas than rural areas (23.03/10 000 vs 7.13/10 000) (OR = 3.23, 95% CI: 3.02-3.47), and the prevalence increased linearly with maternal age ( X trend 2 = 1821.844, P = 0.000). Among the fetuses with CAs, 3097 (97.36%) were diagnosed prenatally, and 3046 (98.35%) underwent TOP. The majority of CA were numerical abnormalities (90.18%). The main types of numerical autosomal abnormalities were trisomy 21 (6.69/10 000, 59.57%), trisomy 18 (1.13/10 000, 10.04%) and trisomy 13 (0.21/10 000, 1.88%). The main types of numerical gonosomal abnormalities were Klinefelter syndrome (0.68/10 000, 6.02%), Turner syndrome (0.49/10 000, 4.39%), Triple X syndrome (0.26/10 000, 2.29%) and 47,XYY syndrome (0.21/10 000, 1.91%). The three associated anomalies with the highest proportions were congenital heart defects (CHD) (41.06%), cleft palate or/and cleft lip (10.89%) and congenital talipes equinovarus (8.94%). CONCLUSION The prevalence of CA was lower than that reported. Chromosome detection should be further promoted including test contest and coverage, especially for urban areas, older mothers and fetuses with CHD, cleft palate or/and cleft lip or congenital talipes equinovarus.
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Affiliation(s)
- Donghua Xie
- Department of Information Management, Maternal and Child Health Hospital of Hunan Province, Changsha, China.,NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Wenzhen Yang
- Department of Health Management, Maternal and Child Health Hospital of Hunan Province, Changsha, China
| | - Junqun Fang
- Department of Health Management, Maternal and Child Health Hospital of Hunan Province, Changsha, China
| | - Haoxian Li
- Obstetrics Department of Shunde Hospital, The First People's Hospital of Shunde, Southern Medical University, Foshan, China
| | - Lili Xiong
- Department of Information Management, Maternal and Child Health Hospital of Hunan Province, Changsha, China
| | - Fanjuan Kong
- Department of Information Management, Maternal and Child Health Hospital of Hunan Province, Changsha, China
| | - Aihua Wang
- Department of Information Management, Maternal and Child Health Hospital of Hunan Province, Changsha, China
| | - Zhiyu Liu
- Department of Information Management, Maternal and Child Health Hospital of Hunan Province, Changsha, China
| | - Hua Wang
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.,Department of Medical Genetics, Maternal and Child Health Hospital of Hunan Province, Changsha, China
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17
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Fang Y, Wang Y, Peng M, Xu J, Fan Z, Liu C, Zhao K, Zhang H. Effect of paternal age on offspring birth defects: a systematic review and meta-analysis. Aging (Albany NY) 2020; 12:25373-25394. [PMID: 33229621 PMCID: PMC7803514 DOI: 10.18632/aging.104141] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/20/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis was aimed at determining whether paternal age is a risk factor for offspring birth defects. RESULTS A total of 38 and 11 studies were included in the systematic review and meta-analysis, respectively. Compared with reference, fathers aged 25 to 29, young fathers (< 20 years) could increase the risk of urogenital abnormalities (OR: 1.50, 95 % CI: 1.03-2.19) and chromosome disorders (OR: 1.38, 95 % CI: 1.12-1.52) in their offsprings; old fathers (≥ 40 years) could increase the risk of cardiovascular abnormalities (OR: 1.10, 95 % CI: 1.01-1.20), facial deformities (OR: 1.08, 95 % CI: 1.00-1.17), urogenital abnormalities (OR: 1.28, 95 % CI: 1.07-1.52), and chromosome disorders (OR: 1.30, 95 % CI: 1.12-1.52). CONCLUSIONS Our study indicated that paternal age is associated with a moderate increase in the incidence of urogenital and cardiovascular abnormalities, facial deformities, and chromosome disorders. METHODS PubMed, Web of Science, the Cochrane Library, and Embase were searched for relevant literatures from 1960 to February 2020. The systematic review follows PRISMA guidelines. Relevant meta-analyses were performed.
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Affiliation(s)
- Yiwei Fang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongfeng Wang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meilin Peng
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Xu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zunpan Fan
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyan Liu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiping Zhang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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18
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Wu JJY, Ng Yin K, Lee KS, Zhang JJY. Re: Association between preconception paternal smoking and birth defects in offspring: evidence from the database of the National Free Preconception Health Examination Project in China. BJOG 2020; 127:1578-1579. [PMID: 32741112 DOI: 10.1111/1471-0528.16414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Jania J Y Wu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kyla Ng Yin
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Keng Siang Lee
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - John J Y Zhang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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19
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Nie Z, Qu Y, Han F, Bell EM, Zhuang J, Chen J, François M, Lipton E, Matale R, Cui W, Liang Q, Lu X, Huang H, Lv J, Ou Y, Mai J, Wu Y, Gao X, Huang Y, Lin S, Liu X. Evaluation of interactive effects between paternal alcohol consumption and paternal socioeconomic status and environmental exposures on congenital heart defects. Birth Defects Res 2020; 112:1273-1286. [PMID: 32696579 DOI: 10.1002/bdr2.1759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND While the maternal risk factors on congenital heart defects (CHDs) have often been assessed, paternal contribution to CHDs, especially the joint effects of paternal risk factors on CHDs remain unknown. This study examined the major impacts of paternal alcohol consumption and its interaction (on multiplicative and additive scales) with paternal socioeconomic status (SES) and environmental exposures on CHDs in China. METHODS A population-based case-control study involving 4,726 singleton CHDs cases and 4,726 controls (without any malformation and matched on hospital, gender, and gestational age) was conducted in Guangdong, China, 2004-2014. Information on parental demographics, behavioral patterns, disease/medication, and environmental exposures (3 months before pregnancy) was collected through face-to-face interviews. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) while controlling for all parental factors. RESULTS Paternal alcohol consumption was associated with an increased OR of CHDs (adjusted OR = 2.87, 95% CI: 2.25-3.65). Additionally, paternal smoking, industry occupation, organic solvent contact, virus infection and antibiotic use, living in rural areas, low household income, and migrant status were significantly associated with CHDs (ORs ranged: 1.42-4.44). Significant additive or multiplicative interactions were observed between paternal alcohol consumption and paternal smoking, industrial occupation, and low income on any CHDs (interaction contrast ratio [ICR] = 4.72, 95% CI: 0.96-8.47] and septal defects (ICRs ranged from 2.04 to 2.79, p < .05). CONCLUSIONS Paternal alcohol consumption and multiple paternal factors were significantly associated with CHDs in China. Paternal smoking and low SES factors modified paternal alcohol consumption-CHDs relationships. Further studies are needed to confirm these findings.
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Affiliation(s)
- Zhiqiang Nie
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yanji Qu
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Fengzhen Han
- Department of Obstetrics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Erin M Bell
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, New York, USA.,Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Albany, New York, USA
| | - Jian Zhuang
- Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jimei Chen
- Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Melissa François
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, New York, USA.,Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Albany, New York, USA
| | - Emily Lipton
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, New York, USA.,Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Albany, New York, USA
| | - Rosemary Matale
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, New York, USA.,Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Albany, New York, USA
| | - Weilun Cui
- Department of Neonatology, Panyu General Hospital, Guangzhou, Guangdong, China
| | - Qianhong Liang
- Department of Echocardiography, Panyu Maternal and Child Care Service Centre, Guangzhou, Guangdong, China
| | - Xiangzhang Lu
- Department of Echocardiography, Huadu Maternal and Child Care Service Centre, Guangzhou, Guangdong, China
| | - Huiwen Huang
- Department of Neonatology, Zhuhai Maternal and Child Care Service Center, Zhuhai, Guangdong, China
| | - Junfeng Lv
- Department of Neonatology, Boai Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Yanqiu Ou
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jinzhuang Mai
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yong Wu
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Xiangmin Gao
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yating Huang
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, New York, USA.,Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Albany, New York, USA
| | - Xiaoqing Liu
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
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20
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Janeczko D, Hołowczuk M, Orzeł A, Klatka B, Semczuk A. Paternal age is affected by genetic abnormalities, perinatal complications and mental health of the offspring. Biomed Rep 2019; 12:83-88. [PMID: 32042416 DOI: 10.3892/br.2019.1266] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/19/2019] [Indexed: 01/05/2023] Open
Abstract
Infertility and fecundity problems concern 10-18% of partners in their reproductive years compromising around one million females and males in Poland. Research and analysis of factors that affect male fertility are limited, especially, regarding the age of the father and determining the age at which quality of semen decreases. Age of the father has greater impact than maternal age, on cases of sporadic autosomal dominant congenital diseases such as Apert, Crouzon, Pfeiffer, Noonan and Costello syndromes, multiple endocrine neoplasia (types 2A and 2B) and achondroplasia. However, there are only a few reports taking paternal advanced age into consideration for pre-mature birth, low Apgar scores or admission to a neonatal intensive care department. Paternal age increases the frequency of congenital diseases such as heart malformations as well as oral, palate and lip cleft. Moreover, mental disorders (autism, schizophrenia, bipolar disorder, low IQ level as well as ADHD) also occur more frequently in advanced father's age. Advanced paternal age is defined differently in every research. It depends on disorders in offspring we are talking about. Paternal age has an impact on child's health and development and it is as significant as maternal age, when it comes to reproductive matters.
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Affiliation(s)
- Dominika Janeczko
- Second Department of Gynecology, Medical University of Lublin, PL-20954 Lublin, Poland
| | - Magdalena Hołowczuk
- Second Department of Gynecology, Medical University of Lublin, PL-20954 Lublin, Poland
| | - Anna Orzeł
- Second Department of Gynecology, Medical University of Lublin, PL-20954 Lublin, Poland
| | - Barbara Klatka
- Second Department of Gynecology, Medical University of Lublin, PL-20954 Lublin, Poland
| | - Andrzej Semczuk
- Second Department of Gynecology, Medical University of Lublin, PL-20954 Lublin, Poland
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21
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Jia S, Wei X, Ma L, Wang Y, Gu H, Liu D, Ma W, Yuan Z. Maternal, paternal, and neonatal risk factors for neural tube defects: A systematic review and meta-analysis. Int J Dev Neurosci 2019; 78:227-235. [PMID: 31563704 DOI: 10.1016/j.ijdevneu.2019.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Neural tube defects [NTDs] are severe congenital anomalies. The etiology of NTDs is not fully known, and studies on the potential risk factors of NTDs present inconsistent results. Thus, we conducted a systematic review and meta-analysis to investigate the maternal, paternal, and neonatal risk factors for NTDs. STUDY DESIGN We systematically reviewed relative original studies published through October 6, 2018 available in Pubmed, Embase and the Cochrane Library without restrictions for language. The selected studies measured maternal, paternal, and neonatal risk factors and examined their associations with NTDs. A meta-analysis, including subgroup analysis and sensitivity analysis, was conducted to estimate the pooled effect measures. Two reviewers independently extracted data using a predesigned data collection form. RESULTS Forty-five studies were eligible for inclusion in the meta-analysis, and twelve potential risk factors were analyzed. The factors that were associated with NTDs risk included stressful life events [odds ratio [OR],1.61; 95% confidence interval [CI], 1.24-2.08; p < 0.001; I2 = 59.2%], low maternal education level [OR, 1.42; 95% CI, 1.19-1.70; p < 0.001; I2 = 47.7%], pregestational diabetes [OR, 2.24; 95% CI, 1.21-4.12; p < 0.010; I2 = 56.3%], low paternal age [OR, 1.41; 95% CI, 1.10-1.81; p = 0.007; I2 = 0.0%], low birth weight [OR, 5.53; 95% CI, 1.95-15.70; p = 0.001; I2 = 98.5%], and neonatal female gender [OR, 1.54; 95% CI, 1.10-2.14; p = 0.012; I2 = 67.8%]. CONCLUSION Stressful life events, pregestational diabetes, low birth weight, and neonatal female gender are risk factors associated with NTDs. Low maternal education level and low paternal age are factors that are moderately associated with NTDs. Further cohort studies are required to verify the factors associated with NTDs and control the risk of this severe birth defect.
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Affiliation(s)
- Shanshan Jia
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Xiaowei Wei
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Ling Ma
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
- Department of Pathophysiology, Basic Science College, China Medical University, Shenyang, PR China
| | - Yanfu Wang
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Hui Gu
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Dan Liu
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Wei Ma
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Zhengwei Yuan
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
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22
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Bergh C, Pinborg A, Wennerholm UB. Parental age and child outcomes. Fertil Steril 2019; 111:1036-1046. [PMID: 31155113 DOI: 10.1016/j.fertnstert.2019.04.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/13/2019] [Accepted: 04/18/2019] [Indexed: 10/26/2022]
Abstract
This review summarizes the impact of parental age on children's health outcomes beyond the perinatal period. In the last decades, delayed parenthood with both men and women has become a public health issue. For women, in particular, the size of this delay is substantial. For a few medical conditions, older parental age has a pronounced effect on child morbidity. For most other outcomes, a more modest effect is evident. Although these effects might be limited on an individual level, they have a substantial impact at the level of population health.
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Affiliation(s)
- Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Anja Pinborg
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital East, Gothenburg, Sweden
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23
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Bamishigbin ON, Dunkel Schetter C, Stanton AL. The antecedents and consequences of adolescent fatherhood: A systematic review. Soc Sci Med 2019; 232:106-119. [DOI: 10.1016/j.socscimed.2019.04.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 03/30/2019] [Accepted: 04/19/2019] [Indexed: 10/27/2022]
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24
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Maeda E, Boivin J, Toyokawa S, Murata K, Saito H. Two-year follow-up of a randomized controlled trial: knowledge and reproductive outcome after online fertility education. Hum Reprod 2019; 33:2035-2042. [PMID: 30265305 PMCID: PMC6195802 DOI: 10.1093/humrep/dey293] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/10/2018] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What are the long-term effects of fertility education on knowledge and reproductive outcome? SUMMARY ANSWER Participants in the intervention group retained some knowledge after 2 years and the partnered women had a new child more quickly than the comparison group. WHAT IS KNOWN ALREADY Fertility education improves knowledge, at least in the short-term. Attitudes toward childbearing and its timing can change after exposure to educational materials. STUDY DESIGN, SIZE, DURATION Participants were recruited via an online social research panel. In the original randomized controlled trial (RCT), knowledge of reproductive-aged participants was assessed before (T1) and immediately after (T2) receiving one of three information brochures: fertility (intervention group), healthy pre-pregnancy (focused on intake of folic acid during pregnancy, control group 1), or family policies in Japan (childcare provision, control group 2). The present follow-up study was conducted 2 years later in January 2017 (T3) with the same participants. PARTICIPANTS/MATERIALS, SETTING, METHODS Of the T1 participants (n = 1455), 383 men and 360 women (51%) responded to the T3 survey. Fertility knowledge measured with the Japanese version of the Cardiff Fertility Knowledge Scale (CFKS-J) and fertility status (e.g. new births, new medical consultations, and the timing of new birth) was assessed. MAIN RESULTS AND THE ROLE OF CHANCE Baseline (T1) characteristics of the T3 participants were well balanced between groups, but T3 participants were older, married, and more educated compared to those lost to follow-up. A repeated-measures analysis of variance showed significant knowledge gains among the intervention group from T1 to T3 (11.2% and 7.0% among men and women, respectively) but no significant change over time for the control groups. There were no differences between groups in the incidence of new births or new medical consultations. However, subgroup analysis showed that timing of new births was accelerated for partnered individuals in the intervention group. Specifically, the proportion of partnered participants at T1 who had a new birth in the first year subsequent to presentation of information was higher in the intervention group versus control group 1 (folic acid): 8.8% versus 1.4% (P = 0.09) among men and 10.6% versus 2.3% (P = 0.03) among women, respectively. The odds ratios (adjusted for age) were 7.8 (95% CI: 0.86-70.7) and 5.2 (95% CI: 1.09-25.0) among men and women, respectively. The timing of births and the proportion of new births during the 2-year follow-up period in the intervention group were similar to that of control group 2 (family policy). The incidence of new medical consultation was higher in the male intervention group (12.0%) than in male control group 2 (family policy, 1.5%, P = 0.04) but similar among women in all groups. LIMITATIONS REASONS FOR CAUTION First, the high attrition rate may limit the generalizability of these findings for longer-term acquisition of fertility knowledge, especially when applied to younger people who were more likely to be lost to follow-up. Second, this is a 2-year follow-up study and the results may change in the longer-term. Finally, we relied on self-reported questionnaire data and there is a possibility that some women were unknowingly pregnant at T1 but this risk should be distributed equally in the three groups through randomization. WIDER IMPLICATIONS OF THE FINDINGS Effects of one-time education were limited but retained beyond baseline levels. Importantly, education was found to potentially accelerate decision-making about achieving births in partnered subgroups compared to receiving healthy pre-pregnancy information. However, this finding should be confirmed in future stratified RCTs designed to evaluate effects in these subgroups. Follow-up 'booster' education sessions might help people retain knowledge and facilitate reproductive decisions for longer. In view of the high attrition rate, especially among young populations, novel educational strategies to retain young people in fertility education cohorts should be explored. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by National Center for Child Health and Development, the Daiwa Anglo-Japanese Foundation, Pfizer Health Research Foundation, and the Japan Society for the Promotion of Science. E.M. reports joint research funds from a public interest incorporated foundation '1 more Baby Ohendan.'
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Satoshi Toyokawa
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuyuki Murata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan
| | - Hidekazu Saito
- Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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25
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Peng J, Meng Z, Zhou S, Zhou Y, Wu Y, Wang Q, Wang J, Sun K. The non-genetic paternal factors for congenital heart defects: A systematic review and meta-analysis. Clin Cardiol 2019; 42:684-691. [PMID: 31073996 PMCID: PMC6605632 DOI: 10.1002/clc.23194] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/03/2019] [Accepted: 05/08/2019] [Indexed: 01/22/2023] Open
Abstract
Background Advances have been made in identifying genetic etiologies and maternal risk factors of congenital heart defects (CHDs), while few literatures are available regarding paternal risk factors for CHDs. Thus, we aim to conduct a meta‐analysis and systematic review about the non‐genetic paternal risk factors for CHDs. Methods We searched the PubMed, MEDLINE, and Cochrane Library online databases and identified 31 studies published between 1990 and 2018 according to the inclusion criteria. Paternal risk factors were divided into subgroups, and summarized odd ratios (OR) were calculated. Results Paternal age between 24 and 29 years decreased the risk of CHDs in the offspring (OR = 0.90 [0.82, 0.98]), while paternal age ≥ 35 years old increased the risk of CHDs (35‐39 years old: OR = 1.14 [1.09, 1.19], and ≥ 40 years: OR = 1.27 [1.14, 1.42]). Paternal cigarette smoking increased the risk of CHDs in a dose‐dependent way. Paternal wine drinking (OR = 1.47 [1.05, 2.07]) and exposure to chemical agents or drugs (OR = 2.15 [1.53, 3.02]) also increased the risk of CHDs. Some specific paternal occupations were also associated with increased risk for CHDs or CHD subtypes including factory workers, janitors, painters, and plywood mill workers. Conclusions This meta‐analysis and systematic review suggested that advanced paternal age, cigarette smoking, wine drinking, exposure to chemical agents or drugs and some specific occupations were associated with an increased risk of CHDs. More measures should be taken to reduce occupational and environment exposures. At the same time, fertility at certain age and establishment of healthy life habits are strongly recommended.
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Affiliation(s)
- Jiayu Peng
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhuo Meng
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Pediatric Cardiology, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shuang Zhou
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yue Zhou
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yujian Wu
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qingjie Wang
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Wang
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Kun Sun
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Pediatric Cardiology, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Hoyt AT, Shumate CJ, Canfield MA, Le M, Ramadhani T, Scheuerle AE. Selected acculturation factors and birth defects in the National Birth Defects Prevention Study, 1997–2011. Birth Defects Res 2019; 111:598-612. [DOI: 10.1002/bdr2.1494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Adrienne T. Hoyt
- Birth Defects Epidemiology and Surveillance BranchTexas Department of State Health Services Austin Texas
| | - Charlie J. Shumate
- Birth Defects Epidemiology and Surveillance BranchTexas Department of State Health Services Austin Texas
| | - Mark A. Canfield
- Birth Defects Epidemiology and Surveillance BranchTexas Department of State Health Services Austin Texas
| | - Mimi Le
- Birth Defects Epidemiology and Surveillance BranchTexas Department of State Health Services Austin Texas
| | - Tunu Ramadhani
- Birth Defects Epidemiology and Surveillance BranchTexas Department of State Health Services Austin Texas
| | - Angela E. Scheuerle
- Birth Defects Epidemiology and Surveillance BranchTexas Department of State Health Services Austin Texas
- Department of Pediatrics, Division of Genetics and Metabolism, University of Texas Southwester Medical Center Dallas Texas
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27
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Birth Defects Among 788 Children Born to Gulf War Veterans Based on Physical Examination. J Occup Environ Med 2019; 61:263-270. [DOI: 10.1097/jom.0000000000001508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Cito G, Coccia ME, Picone R, Cocci A, Russo GI, Garaffa G, Fucci R, Bertocci F, Borrani E, Basile V, Micelli E, Criscuoli L, Serni S, Carini M, Natali A. Impact of advanced paternal age on the intracytoplasmic sperm injection (ICSI) outcomes in donor egg cycles. Transl Androl Urol 2019; 8:S22-S30. [PMID: 31143668 DOI: 10.21037/tau.2018.12.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background The purpose of this study is to assess the impact of paternal age on the oocyte-donation outcomes in intracytoplasmic sperm injection (ICSI) cycles. Methods Two hundred and seventy-eight infertile couples were retrospectively involved. Inclusion criteria were: infertility from almost 1 year, normal or sub-fertile seminal parameters, overall oocyte survival rate greater than 85%. Baseline characteristics included male age, recipient age, male body mass index (BMI), smoking, drinking status. Main outcome measures: fertilization rate (FR), cleavage rate (CR), pregnancy rate (PR). Results Patients were categorized in group 1 ≤45, group 2 >45 years. A total of 1,724 frozen oocytes were included. After warming, 1,642 oocytes survived. Median overall oocyte survival rate was 100% [interquartile range (IQR), 85-100%]. Median male age was 44±5.60 years (IQR, 31-70 years). Median recipients age was 42±3.62 years (IQR, 29-50 years). Group 1 included 166 men, group 2 112 men. Two hundred and seventy-eight fresh ICSI cycle were performed. "Two-pronuclear" (2PN) FR was 72.6%±0.20%, CR 93.0%±0.16%, PR 39.6%. Miscarriage rate was 25.5%. Live birth rate per cycles was 29.5%. Comparison between group 1, group 2 and ICSI outcomes confirmed an association with FR, resulting 80.0% (IQR, 67.0-83.0%) and 67.0% (IQR, 50.0-80.0%), respectively (P<0.01). There were no significant differences between the two groups with respect to seminal parameters. Conclusions It would be recommended more emphasis on the advancing male age when counselling older couples who undergo egg donation program.
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Affiliation(s)
- Gianmartin Cito
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Giorgio Ivan Russo
- Department of Urology, Vittorio Emanuele II, University of Catania, Catania, Italy
| | - Giulio Garaffa
- Institute of Urology, University College London Hospitals, London, UK
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesco Bertocci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elena Borrani
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Valentina Basile
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Department of Obstetrics and Gynecology, Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Luciana Criscuoli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
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Maternal risk factors associated with neural tube defects in Tigray regional state of Ethiopia. Brain Dev 2019; 41:11-18. [PMID: 30075882 DOI: 10.1016/j.braindev.2018.07.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/11/2018] [Accepted: 07/14/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Unlike developing countries, including Ethiopia the identification of the risk factors in decreasing the burden of neural tube defects (NTDs) is well established in the developed world. Hence, we sought to determine the factors associated with NTDs in Tigray - Ethiopia. METHODS We undergo a case-control analysis where all NTDs cases were compared to a group of controls derived randomly from the same hospitals where cases were recruited from. The NTDs survey tool which contains a standard questionnaire was prepared. Parental socio-demographic and clinical information such, maternal age, obstetric history, illnesses, drug intake, radiation, occupation, education, history of congenital anomalies, residence, exposure to pollutants such as smoking, chemicals, paternal history, and folic acid utilization was collected and analyzed using SPSS version 20. RESULT This study has shown the maternal age, and residency, birth order 3 and 4, unplanned pregnancy, history of breastfeeding above 2 years, history of stillbirths, history of male gender predominance were found to have a strong association with an occurrence of NTDs (p = 0.0001). Though the binary logistic regression analysis showed no significant association in some of the risk factors such as maternal health and drug history, the frequency analysis showed they may have an impact on the incidence of NTDs. CONCLUSION This study has shown the majority of the maternal risk factors and other lifestyle patterns had a significant impact on the occurrence of NTDs. Therefore, efficient monitoring of NTDs in Ethiopia is vital, so our study could be groundwork information in Ethiopia for future programs.
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Mayo JA, Lu Y, Stevenson DK, Shaw GM, Eisenberg ML. Parental age and stillbirth: a population-based cohort of nearly 10 million California deliveries from 1991 to 2011. Ann Epidemiol 2018; 31:32-37.e2. [PMID: 30642694 DOI: 10.1016/j.annepidem.2018.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/15/2018] [Accepted: 12/01/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Parental age at delivery in the United States has been rising. Advanced maternal and paternal ages have been associated with adverse pregnancy outcomes including stillbirth. However, these relationships come from studies that often do not present results for both mother and father concurrently. The purpose of this study was to estimate the risk of stillbirth for maternal and paternal age in the same cohort of deliveries. METHODS This is a population-based cohort study of all live birth and stillbirth deliveries in California from 1991 to 2011. The individual associations between maternal and paternal ages and stillbirth were estimated with hazard ratios from Cox proportional hazard models. Age was modeled continuously with restricted cubic splines to account for nonlinear relationships. Mean parental age was used as the referent group. RESULTS J-shaped associations between maternal and paternal ages were observed in crude models where older mothers and fathers had the highest hazard ratios for stillbirth. In maternal models, after adjusting for maternal and paternal covariates, young maternal age no longer showed increased hazard ratio for stillbirth, whereas the association with older mothers remained. In adjusted paternal models, the relationship between young paternal age and stillbirth was unchanged while the hazard ratio for older fathers was slightly smaller. CONCLUSIONS After adjusting for both parents' age, education, race/ethnicity, along with parity, older mothers and fathers were independently associated with elevated hazard ratios for stillbirth.
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Affiliation(s)
- Jonathan A Mayo
- March of Dimes Prematurity Research Center, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
| | - Ying Lu
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA
| | - David K Stevenson
- March of Dimes Prematurity Research Center, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Gary M Shaw
- March of Dimes Prematurity Research Center, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Michael L Eisenberg
- Departments of Urology and Obstetrics/Gynecology, Stanford University School of Medicine, Stanford, CA
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Oldereid NB, Wennerholm UB, Pinborg A, Loft A, Laivuori H, Petzold M, Romundstad LB, Söderström-Anttila V, Bergh C. The effect of paternal factors on perinatal and paediatric outcomes: a systematic review and meta-analysis. Hum Reprod Update 2018; 24:320-389. [PMID: 29471389 DOI: 10.1093/humupd/dmy005] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/21/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Maternal factors, including increasing childbearing age and various life-style factors, are associated with poorer short- and long-term outcomes for children, whereas knowledge of paternal parameters is limited. Recently, increasing paternal age has been associated with adverse obstetric outcomes, birth defects, autism spectrum disorders and schizophrenia in children. OBJECTIVE AND RATIONALE The aim of this systematic review is to describe the influence of paternal factors on adverse short- and long-term child outcomes. SEARCH METHODS PubMed, Embase and Cochrane databases up to January 2017 were searched. Paternal factors examined included paternal age and life-style factors such as body mass index (BMI), adiposity and cigarette smoking. The outcome variables assessed were short-term outcomes such as preterm birth, low birth weight, small for gestational age (SGA), stillbirth, birth defects and chromosomal anomalies. Long-term outcome variables included mortality, cancers, psychiatric diseases/disorders and metabolic diseases. The systematic review follows PRISMA guidelines. Relevant meta-analyses were performed. OUTCOMES The search included 14 371 articles out of which 238 met the inclusion criteria, and 81 were included in quantitative synthesis (meta-analyses). Paternal age and paternal life-style factors have an association with adverse outcome in offspring. This is particularly evident for psychiatric disorders such as autism, autism spectrum disorders and schizophrenia, but an association is also found with stillbirth, any birth defects, orofacial clefts and trisomy 21. Paternal height, but not BMI, is associated with birth weight in offspring while paternal BMI is associated with BMI, weight and/or body fat in childhood. Paternal smoking is found to be associated with an increase in SGA, birth defects such as congenital heart defects, and orofacial clefts, cancers, brain tumours and acute lymphoblastic leukaemia. These associations are significant although moderate in size, with most pooled estimates between 1.05 and 1.5, and none exceeding 2.0. WIDER IMPLICATIONS Although the increased risks of adverse outcome in offspring associated with paternal factors and identified in this report represent serious health effects, the magnitude of these effects seems modest.
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Affiliation(s)
- Nan B Oldereid
- Livio IVF-klinikken Oslo, Sørkedalsveien 10A, 0369 Oslo, Norway
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital East, SE 416 85 Gothenburg, Sweden
| | - Anja Pinborg
- Department of Obstetrics and Gynecology, Hvidovre Hospital, Institute of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Loft
- Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Hannele Laivuori
- Department of Obstetrics and Gynecology, Tampere University Hospital, Teiskontie 35, FI-33521 Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Arvo Ylpön katu 34, FI-33520 Tampere, Finland.,Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 8, FI-00290 Helsinki, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Tukhomankatu 8, FI-00290 Helsinki, Finland
| | - Max Petzold
- Swedish National Data Service and Health Metrics Unit, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Liv Bente Romundstad
- Spiren Fertility Clinic, Norwegian University of Science and Technology, Trondheim NO-7010, Norway.,Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
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Bertoncelli Tanaka M, Agarwal A, Esteves SC. Paternal age and assisted reproductive technology: problem solver or trouble maker? Panminerva Med 2018; 61:138-151. [PMID: 30021419 DOI: 10.23736/s0031-0808.18.03512-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In our society, the number of couples with advanced reproductive age seeking fertility treatment is increasing steadily. While the negative effect of female age on assisted reproductive technology (ART) outcomes is well established, the impact of paternal age needs to be clarified. We reviewed the current literature to determine whether advanced paternal age affects the results of ART and the health of resulting offspring. We found that the published literature is overall supportive of a positive association between advanced paternal age (>40 years) and semen quality deterioration. However, the existing evidence does not corroborate nor discard the influence of advanced paternal age on ART outcomes. Similarly, the effect of paternal age on the health of ART offspring remains equivocal, although data from naturally-conceived children clearly indicates that advanced paternal age increases the frequency of genetic, neurodevelopmental, and psychiatric diseases in the progeny. Noteworthy, the current literature is limited and subjected to bias due to the impact of maternal age as a critical confounder. Health care providers should discuss with concerned couples the available options to counteract the possible negative influence of advanced paternal age on ART outcomes and health of resulting offspring. These include identification and treatment of underlying conditions with potential negative long-term effects on fertility, sperm freezing at a young age, and use of antioxidant supplements for men at risk of excessive oxidative stress. Aged male partner from couples undergoing ART, in particular men of 50 years and older, should consider use of preimplantation genetic testing as a means to detect embryo abnormalities and select euploid embryos for transfer to the uterine cavity.
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Affiliation(s)
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Sandro C Esteves
- Division of Urology, Department of Surgery, University of Campinas (UNICAMP), Campinas, Brazil - .,Andrology and Human Reproduction Clinic ANDROFERT, Campinas, Brazil.,Faculty of Health, Aarhus University, Aarhus, Denmark
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Yatsenko AN, Turek PJ. Reproductive genetics and the aging male. J Assist Reprod Genet 2018; 35:933-941. [PMID: 29524155 PMCID: PMC6030011 DOI: 10.1007/s10815-018-1148-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/25/2018] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To examine current evidence of the known effects of advanced paternal age on sperm genetic and epigenetic changes and associated birth defects and diseases in offspring. METHODS Review of published PubMed literature. RESULTS Advanced paternal age (> 40 years) is associated with accumulated damage to sperm DNA and mitotic and meiotic quality control mechanisms (mismatch repair) during spermatogenesis. This in turn causes well-delineated abnormalities in sperm chromosomes, both numerical and structural, and increased sperm DNA fragmentation (3%/year of age) and single gene mutations (relative risk, RR 10). An increase in related abnormalities in offspring has also been described, including miscarriage (RR 2) and fetal loss (RR 2). There is also a significant increase in rare, single gene disorders (RR 1.3 to 12) and congenital anomalies (RR 1.2) in offspring. Current research also suggests that autism, schizophrenia, and other forms of "psychiatric morbidity" are more likely in offspring (RR 1.5 to 5.7) with advanced paternal age. Genetic defects related to faulty sperm quality control leading to single gene mutations and epigenetic alterations in several genetic pathways have been implicated as root causes. CONCLUSIONS Advanced paternal age is associated with increased genetic and epigenetic risk to offspring. However, the precise age at which risk develops and the magnitude of the risk are poorly understood or may have gradual effects. Currently, there are no clinical screenings or diagnostic panels that target disorders associated with advanced paternal age. Concerned couples and care providers should pursue or recommend genetic counseling and prenatal testing regarding specific disorders.
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Affiliation(s)
- Alexander N. Yatsenko
- Department of OB/GYN and Reproductive Sciences, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Room A206, Pittsburgh, PA 15213 USA
| | - Paul J. Turek
- The Turek Clinics, 55 Francisco St., Suite 300, San Francisco, CA 94133 USA
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Nembhard WN, Tang X, Li J, MacLeod SL, Levy J, Schaefer GB, Hobbs CA. A parent-of-origin analysis of paternal genetic variants and increased risk of conotruncal heart defects. Am J Med Genet A 2018; 176:609-617. [PMID: 29399948 DOI: 10.1002/ajmg.a.38611] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/04/2017] [Accepted: 12/26/2017] [Indexed: 12/12/2022]
Abstract
The association between conotruncal heart defects (CTHDs) and maternal genetic and environmental exposures is well studied. However, little is known about paternal genetic or environmental exposures and risk of CTHDs. We assessed the effect of paternal genetic variants in the folate, homocysteine, and transsulfuration pathways on risk of CTHDs in offspring. We utilized National Birth Defects Prevention Study data to conduct a family-based case only study using 616 live-born infants with CTHDs, born October 1997-August 2008. Maternal, paternal and infant DNA was genotyped using an Illumina® Golden Gate custom single nucleotide polymorphism (SNP) panel. Relative risks (RR) and 95% confidence intervals (CI) from log-linear models determined parent of origin effects for 921 SNPs in 60 candidate genes involved in the folate, homocysteine, and transsulfuration pathways on risk of CTHDs. The risk of CTHD among children who inherited a paternally derived copy of the A allele on GLRX (rs17085159) or the T allele of GLRX (rs12109442) was 0.23 (95%CI: 0.12, 0.42; p = 1.09 × 10-6 ) and 0.27 (95%CI: 0.14, 0.50; p = 2.06 × 10-5 ) times the risk among children who inherited a maternal copy of the same allele. The paternally inherited copy of the GSR (rs7818511) A allele had a 0.31 (95%CI: 0.18, 0.53; p = 9.94 × 10-6 ] risk of CTHD compared to children with the maternal copy of the same allele. The risk of CTHD is less influenced by variants in paternal genes involved in the folate, homocysteine, or transsulfuration pathways than variants in maternal genes in those pathways.
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Affiliation(s)
- Wendy N Nembhard
- Division of Birth Defects Research, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, Arkansas.,Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Xinyu Tang
- Division of Biostatistics, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Jingyun Li
- Division of Biostatistics, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Stewart L MacLeod
- Division of Birth Defects Research, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Joseph Levy
- Division of Birth Defects Research, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Gerald B Schaefer
- Division of Genetics and Metabolism, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Charlotte A Hobbs
- Division of Birth Defects Research, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, Arkansas
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Gajos JM, Beaver KM. The Role of Paternal Age in the Prediction of Offspring Intelligence. The Journal of Genetic Psychology 2017; 178:319-333. [PMID: 29099674 DOI: 10.1080/00221325.2017.1377678] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Recent evidence suggests that paternal age at birth influences myriad developmental outcomes among children, but few studies have examined the possibility for father's age to influence children's intellectual development among a sample of high-risk families. The authors use data from the Fragile Families and Child Wellbeing Study to examine the association between paternal age at birth among 480 male and 449 female children's verbal IQ scores, as assessed with a version of the Peabody Picture Vocabulary Test at 9 years old. The nonlinear association between paternal age and children's verbal intelligence was also examined. Paternal age at birth appears to have a marginally significant nonlinear relationship with male children's verbal IQ scores, despite controlling for a number of possible confounders associated with both young and advanced paternal age.
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Affiliation(s)
- Jamie M Gajos
- a The Methodology Center and Bennett Pierce Prevention Research Center, College of Health and Human Development , The Pennsylvania State University , University Park , Pennsylvania , USA
| | - Kevin M Beaver
- b College of Criminology and Criminal Justice , Florida State University , Tallahassee , Florida , USA.,c Center for Social and Humanities Research , King Abdulaziz University , Jeddah , Saudi Arabia
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Hurley EG, DeFranco EA. Influence of paternal age on perinatal outcomes. Am J Obstet Gynecol 2017; 217:566.e1-566.e6. [PMID: 28784418 DOI: 10.1016/j.ajog.2017.07.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/19/2017] [Accepted: 07/31/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is an increasing trend to delay childbearing to advanced parental age. Increased risks of advanced maternal age and assisted reproductive technologies are widely accepted. There are limited data regarding advanced paternal age. To adequately counsel patients on risk, more research regarding advanced paternal age is necessary. OBJECTIVE We sought to determine the influence of paternal age on perinatal outcomes, and to assess whether this influence differs between pregnancies achieved spontaneously and those achieved with assisted reproductive technology. STUDY DESIGN A population-based retrospective cohort study of all live births in Ohio from 2006 through 2012 was completed. Data were evaluated to determine if advanced paternal age is associated with an increased risk of adverse outcomes in pregnancies. The analysis was stratified by status of utilization of assisted reproductive technology. Generalized linear regression models assessed the association of paternal age on pregnancy complications in assisted reproductive technology and spontaneously conceived pregnancies, after adjusting for maternal age, race, multifetal gestation, and Medicaid status, using Stata software (Stata, Release 12; StataCorp, College Station, TX). RESULTS Paternal age was documented in 82.2% of 1,034,552 live births in Ohio during the 7-year study period. Paternal age ranged from 12-87 years, with a median of 30 (interquartile range, 26-35) years. Maternal age ranged from 11-62 years, with a median of 27 (interquartile range, 22-31) years. The use of assisted reproductive technology in live births increased as paternal age increased: 0.1% <30 years vs 2.5% >60 years, P < .001. After accounting for maternal age and other confounding risk factors, increased paternal age was not associated with a significant increase in the rate of preeclampsia, preterm birth, fetal growth restriction, congenital anomaly, genetic disorder, or neonatal intensive care unit admission. The influence of paternal age on pregnancy outcomes was similar in pregnancies achieved with and without assisted reproductive technology. CONCLUSION Older paternal age does not appear to pose an independent risk of adverse perinatal outcomes, in pregnancies achieved either with or without assisted reproductive technology. However, small effect sizes such as very small risk increases or decreases may not be detectable despite the large sample size in this study of >830,000 births.
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Donnan J, Walsh S, Sikora L, Morrissey A, Collins K, MacDonald D. A systematic review of the risks factors associated with the onset and natural progression of spina bifida. Neurotoxicology 2017; 61:20-31. [DOI: 10.1016/j.neuro.2016.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 03/09/2016] [Indexed: 12/14/2022]
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Harris BS, Bishop KC, Kemeny HR, Walker JS, Rhee E, Kuller JA. Risk Factors for Birth Defects. Obstet Gynecol Surv 2017; 72:123-135. [PMID: 28218773 DOI: 10.1097/ogx.0000000000000405] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Importance Major congenital abnormalities, or birth defects, carry significant medical, surgical, cosmetic, or lifestyle consequences. Such abnormalities may be syndromic, involving multiple organ systems, or can be isolated. Overall, 2% to 4% of live births involve congenital abnormalities. Risk factors for birth defects are categorized as modifiable and nonmodifiable. Modifiable risk factors require thorough patient education/counseling. The strongest risk factors, such as age, family history, and a previously affected child, are usually nonmodifiable. Objective This review focuses on risk factors for birth defects including alcohol consumption, illicit drug use, smoking, obesity, pregestational diabetes, maternal phenylketonuria, multiple gestation, advanced maternal age, advanced paternal age, family history/consanguinity, folic acid deficiency, medication exposure, and radiation exposure. Evidence Acquisition Literature review via PubMed. Results There is a strong link between alcohol use, folic acid deficiency, obesity, uncontrolled maternal diabetes mellitus, uncontrolled maternal phenylketonuria, and monozygotic twins and an increased risk of congenital anomalies. Advanced maternal age confers an increased risk of aneuploidy, as well as nonchromosomal abnormalities. Some medications, including angiotensin converting enzyme inhibitors, retinoic acid, folic acid antagonists, and certain anticonvulsants, are associated with various birth defects. However, there are few proven links between illicit drug use, smoking, advanced paternal age, radiation exposure, and statins with specific birth defects. Conclusions and Relevance Birth defects are associated with multiple modifiable and nonmodifiable risk factors. Obstetrics providers should work with patients to minimize their risk of birth defects if modifiable risk factors are present and to appropriately counsel patients when nonmodifiable risk factors are present.
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Affiliation(s)
| | | | - Hanna R Kemeny
- Medical Student, Duke University School of Medicine, Durham
| | - Jennifer S Walker
- Research Librarian, Health Sciences Library, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Jeffrey A Kuller
- Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC
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Sunitha T, Rebekah Prasoona K, Muni Kumari T, Srinadh B, Laxmi Naga Deepika M, Aruna R, Jyothy A. Risk factors for congenital anomalies in high risk pregnant women: A large study from South India. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2017. [DOI: 10.1016/j.ejmhg.2016.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Maeda E, Nakamura F, Boivin J, Kobayashi Y, Sugimori H, Saito H. Fertility knowledge and the timing of first childbearing: a cross-sectional study in Japan. HUM FERTIL 2016; 19:275-281. [PMID: 27701914 DOI: 10.1080/14647273.2016.1239033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Although fertility educational initiatives have increased in developed countries to prevent infertility and to broaden fertility choices, the relationship between knowledge and behaviour is still poorly understood. In order to investigate the association between fertility knowledge and timing of childbearing, we investigated male and female participants between 35 and 44 years of age who had children (n = 640) from an online survey conducted in Japan in 2013. The age at which participants actually gave birth to or fathered their first child was compared between those who were aware for at least a decade of age-related decline in female fertility (hereinafter, those with past fertility knowledge) and those without. Age at first birth was significantly younger and more narrowly distributed among women with past fertility knowledge than among those without: 28.2 ± 3.4 vs. 29.8 ± 4.6 (mean ± SD). A multivariate linear regression analysis showed that women with past fertility knowledge gave birth to their first child 2.34 [95% confidence interval (CI): 1.09-3.59] years earlier compared to those without such knowledge. No significant relation existed among men. Being informed in young adulthood about the facts of fertility might be related to starting a family at an earlier age, although further longitudinal evaluation will be necessary.
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Affiliation(s)
- Eri Maeda
- a Department of Public Health, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan.,b Department of Environmental Health Sciences , Akita University Graduate School of Medicine , Akita , Japan.,c Research Fellow of Japan Society for the Promotion of Science
| | - Fumiaki Nakamura
- a Department of Public Health, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan
| | - Jacky Boivin
- d Cardiff Fertility Studies Research Group , School of Psychology Cardiff University , Cardiff , UK
| | - Yasuki Kobayashi
- a Department of Public Health, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan
| | - Hiroki Sugimori
- e Department of Preventive Medicine, Graduate School of Sports and Health Sciences , Daito Bunka University , Saitama , Japan
| | - Hidekazu Saito
- f Center of Maternal-Fetal, Neonatal and Reproductive Medicine , National Center for Child Health and Development , Tokyo , Japan
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Sotonica M, Mackic-Djurovic M, Hasic S, Kiseljakovic E, Jadric R, Ibrulj S. Association of Parental Age and the Type of Down Syndrome on the Territory of Bosnia and Herzegovina. Med Arch 2016; 70:88-91. [PMID: 27147778 PMCID: PMC4851533 DOI: 10.5455/medarh.2016.70.88-91] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 02/25/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Advanced paternal and/or maternal age is a classic risk factor for Down syndrome. The aim of the study was to investigate the frequency of Down syndrome types in children and its association with maternal and paternal age in Bosnia and Herzegovina. SUBJECTS AND METHODS The cross sectional, observational study included 127 children, 49 girls and 78 boys, aged 1-180 months suspected to have Down syndrome, admitted to the Centre for Genetics, Faculty of Medicine University of Sarajevo, for cytogenetic analysis and differential diagnosis of Down syndrome during the period from January 2010 to May 2015. Standard method of 72 hours cultivation of peripheral blood lymphocytes has been applied. The accepted level of statistical significance was p<0.05. STUDY RESULTS The most common type of Down syndrome was standard trisomy (86.6%), comparing to translocation and mosaicism (7.1%; 6.3%, respectively). The highest frequency of Down syndrome cases was in mother and father's group from 30-39 years old (57; 57 children, respectively) compared to mother and father's groups with younger than 30 (44; 29, respectively) and 40 and older (26; 41, respectively). The significant difference was found in maternal age between translocation and mosaicism groups (p=0.036). Difference between parental years and type of Down syndrome was significant when Standard trisomy 21 and translocation (p=0.045), as well as mosaicism and translocation (p=0.036), were compared. CONCLUSION The most common type of Down syndrome was standard trisomy 21, with highest occurrence in parents from 30 to 39 years old. Parents were the youngest in translocation group. Obtained results suggest that multidisciplinary approach to identifying the trigger for trisomy appearance and the influence of maternal age is required.
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Affiliation(s)
- Mia Sotonica
- Department of Medical Biochemistry, Faculty of Medicine University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Mirela Mackic-Djurovic
- Centre for Genetics, Faculty of Medicine University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Sabaheta Hasic
- Department of Medical Biochemistry, Faculty of Medicine University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Emina Kiseljakovic
- Department of Medical Biochemistry, Faculty of Medicine University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Radivoj Jadric
- Department of Medical Biochemistry, Faculty of Medicine University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Slavka Ibrulj
- Centre for Genetics, Faculty of Medicine University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Atta CAM, Fiest KM, Frolkis AD, Jette N, Pringsheim T, St Germaine-Smith C, Rajapakse T, Kaplan GG, Metcalfe A. Global Birth Prevalence of Spina Bifida by Folic Acid Fortification Status: A Systematic Review and Meta-Analysis. Am J Public Health 2016; 106:e24-34. [PMID: 26562127 PMCID: PMC4695937 DOI: 10.2105/ajph.2015.302902] [Citation(s) in RCA: 198] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Birth defects remain a significant source of worldwide morbidity and mortality. Strong scientific evidence shows that folic acid fortification of a region's food supply leads to a decrease in spina bifida (a birth defect of the spine). Still, many countries around the world have yet to approve mandatory fortification through government legislation. OBJECTIVES We sought to perform a systematic review and meta-analysis of period prevalence of spina bifida by folic acid fortification status, geographic region, and study population. SEARCH METHODS An expert research librarian used terms related to neural tube defects and epidemiology from primary research from 1985 to 2010 to search in EMBASE and MEDLINE. We searched the reference lists of included articles and key review articles identified by experts. SELECTION CRITERIA Inclusion criteria included studies in English or French reporting on prevalence published between January 1985 and December 2010 that (1) were primary research, (2) were population-based, and (3) reported a point or period prevalence estimate of spina bifida (i.e., prevalence estimate with confidence intervals or case numerator and population denominator). Two independent reviewers screened titles and abstracts for eligible articles, then 2 authors screened full texts in duplicate for final inclusion. Disagreements were resolved through consensus or a third party. DATA COLLECTION AND ANALYSIS We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses, or PRISMA, abstracting data related to case ascertainment, study population, folic acid fortification status, geographic region, and prevalence estimate independently and in duplicate. We extracted overall data and any subgroups reported by age, gender, time period, or type of spina bifida. We classified each period prevalence estimate as "mandatory" or "voluntary" folic acid fortification according to each country's folic acid fortification status at the time data were collected (as determined by a well-recognized fortification monitoring body, Food Fortification Initiative). We determined study quality on the basis of sample representativeness, standardization of data collection and birth defect assessment, and statistical analyses. We analyzed study-level period prevalence estimates by using a random effects model (α level of < 0.05) for all meta-analyses. We stratified pooled period prevalence estimates by birth population, fortification status, and continent. RESULTS Of 4078 studies identified, we included 179 studies in the systematic review and 123 in a meta-analysis. In studies of live births (LBs) alone, period prevalences of spina bifida were (1) lower in geographical regions with mandatory (33.86 per 100,000 LBs) versus voluntary (48.35 per 100,000 LBs) folic acid fortification, and (2) lower in studies of LBs, stillbirths, and terminations of pregnancy in regions with mandatory (35.22 per 100,000 LBs) versus voluntary (52.29 per 100,000 LBs) fortification. In LBs, stillbirths, and terminations of pregnancy studies, the lowest pooled prevalence estimate was in North America (38.70 per 100,000). Case ascertainment, surveillance methods, and reporting varied across these population-based studies. CONCLUSIONS Mandatory legislation enforcing folic acid fortification of the food supply lags behind the evidence, particularly in Asian and European countries. This extensive literature review shows that spina bifida is significantly more common in world regions without government legislation regulating full-coverage folic acid fortification of the food supply (i.e., Asia, Europe) and that mandatory folic acid fortification resulted in a lower prevalence of spina bifida regardless of the type of birth cohort. African data were scarce, but needed, as many African nations are beginning to adopt folic acid legislation.
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Affiliation(s)
- Callie A M Atta
- Callie A. M. Atta, Kirsten M. Fiest, Nathalie Jette, Tamara Pringsheim, and Christine St Germaine-Smith are with the Department of Clinical Neurosciences, University of Calgary, Alberta. Kirsten M. Fiest and Nathalie Jette are also with Hotchkiss Brain Institute, University of Calgary. Tamara Pringsheim and Thilinie Rajapakse are with the Department of Paediatrics, University of Calgary. Kirsten M. Fiest, Alexandra D. Frolkis, Nathalie Jette, Tamara Pringsheim, and Gilaad G. Kaplan are with Department of Community Health Sciences, University of Calgary. Amy Metcalfe is with the Department of Obstetrics and Gynecology, University of Calgary
| | - Kirsten M Fiest
- Callie A. M. Atta, Kirsten M. Fiest, Nathalie Jette, Tamara Pringsheim, and Christine St Germaine-Smith are with the Department of Clinical Neurosciences, University of Calgary, Alberta. Kirsten M. Fiest and Nathalie Jette are also with Hotchkiss Brain Institute, University of Calgary. Tamara Pringsheim and Thilinie Rajapakse are with the Department of Paediatrics, University of Calgary. Kirsten M. Fiest, Alexandra D. Frolkis, Nathalie Jette, Tamara Pringsheim, and Gilaad G. Kaplan are with Department of Community Health Sciences, University of Calgary. Amy Metcalfe is with the Department of Obstetrics and Gynecology, University of Calgary
| | - Alexandra D Frolkis
- Callie A. M. Atta, Kirsten M. Fiest, Nathalie Jette, Tamara Pringsheim, and Christine St Germaine-Smith are with the Department of Clinical Neurosciences, University of Calgary, Alberta. Kirsten M. Fiest and Nathalie Jette are also with Hotchkiss Brain Institute, University of Calgary. Tamara Pringsheim and Thilinie Rajapakse are with the Department of Paediatrics, University of Calgary. Kirsten M. Fiest, Alexandra D. Frolkis, Nathalie Jette, Tamara Pringsheim, and Gilaad G. Kaplan are with Department of Community Health Sciences, University of Calgary. Amy Metcalfe is with the Department of Obstetrics and Gynecology, University of Calgary
| | - Nathalie Jette
- Callie A. M. Atta, Kirsten M. Fiest, Nathalie Jette, Tamara Pringsheim, and Christine St Germaine-Smith are with the Department of Clinical Neurosciences, University of Calgary, Alberta. Kirsten M. Fiest and Nathalie Jette are also with Hotchkiss Brain Institute, University of Calgary. Tamara Pringsheim and Thilinie Rajapakse are with the Department of Paediatrics, University of Calgary. Kirsten M. Fiest, Alexandra D. Frolkis, Nathalie Jette, Tamara Pringsheim, and Gilaad G. Kaplan are with Department of Community Health Sciences, University of Calgary. Amy Metcalfe is with the Department of Obstetrics and Gynecology, University of Calgary
| | - Tamara Pringsheim
- Callie A. M. Atta, Kirsten M. Fiest, Nathalie Jette, Tamara Pringsheim, and Christine St Germaine-Smith are with the Department of Clinical Neurosciences, University of Calgary, Alberta. Kirsten M. Fiest and Nathalie Jette are also with Hotchkiss Brain Institute, University of Calgary. Tamara Pringsheim and Thilinie Rajapakse are with the Department of Paediatrics, University of Calgary. Kirsten M. Fiest, Alexandra D. Frolkis, Nathalie Jette, Tamara Pringsheim, and Gilaad G. Kaplan are with Department of Community Health Sciences, University of Calgary. Amy Metcalfe is with the Department of Obstetrics and Gynecology, University of Calgary
| | - Christine St Germaine-Smith
- Callie A. M. Atta, Kirsten M. Fiest, Nathalie Jette, Tamara Pringsheim, and Christine St Germaine-Smith are with the Department of Clinical Neurosciences, University of Calgary, Alberta. Kirsten M. Fiest and Nathalie Jette are also with Hotchkiss Brain Institute, University of Calgary. Tamara Pringsheim and Thilinie Rajapakse are with the Department of Paediatrics, University of Calgary. Kirsten M. Fiest, Alexandra D. Frolkis, Nathalie Jette, Tamara Pringsheim, and Gilaad G. Kaplan are with Department of Community Health Sciences, University of Calgary. Amy Metcalfe is with the Department of Obstetrics and Gynecology, University of Calgary
| | - Thilinie Rajapakse
- Callie A. M. Atta, Kirsten M. Fiest, Nathalie Jette, Tamara Pringsheim, and Christine St Germaine-Smith are with the Department of Clinical Neurosciences, University of Calgary, Alberta. Kirsten M. Fiest and Nathalie Jette are also with Hotchkiss Brain Institute, University of Calgary. Tamara Pringsheim and Thilinie Rajapakse are with the Department of Paediatrics, University of Calgary. Kirsten M. Fiest, Alexandra D. Frolkis, Nathalie Jette, Tamara Pringsheim, and Gilaad G. Kaplan are with Department of Community Health Sciences, University of Calgary. Amy Metcalfe is with the Department of Obstetrics and Gynecology, University of Calgary
| | - Gilaad G Kaplan
- Callie A. M. Atta, Kirsten M. Fiest, Nathalie Jette, Tamara Pringsheim, and Christine St Germaine-Smith are with the Department of Clinical Neurosciences, University of Calgary, Alberta. Kirsten M. Fiest and Nathalie Jette are also with Hotchkiss Brain Institute, University of Calgary. Tamara Pringsheim and Thilinie Rajapakse are with the Department of Paediatrics, University of Calgary. Kirsten M. Fiest, Alexandra D. Frolkis, Nathalie Jette, Tamara Pringsheim, and Gilaad G. Kaplan are with Department of Community Health Sciences, University of Calgary. Amy Metcalfe is with the Department of Obstetrics and Gynecology, University of Calgary
| | - Amy Metcalfe
- Callie A. M. Atta, Kirsten M. Fiest, Nathalie Jette, Tamara Pringsheim, and Christine St Germaine-Smith are with the Department of Clinical Neurosciences, University of Calgary, Alberta. Kirsten M. Fiest and Nathalie Jette are also with Hotchkiss Brain Institute, University of Calgary. Tamara Pringsheim and Thilinie Rajapakse are with the Department of Paediatrics, University of Calgary. Kirsten M. Fiest, Alexandra D. Frolkis, Nathalie Jette, Tamara Pringsheim, and Gilaad G. Kaplan are with Department of Community Health Sciences, University of Calgary. Amy Metcalfe is with the Department of Obstetrics and Gynecology, University of Calgary
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Urhoj SK, Mortensen LH, Nybo Andersen AM. Advanced Paternal Age and Risk of Musculoskeletal Congenital Anomalies in Offspring. ACTA ACUST UNITED AC 2015; 104:273-80. [PMID: 26663788 DOI: 10.1002/bdrb.21167] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 11/12/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Previous research suggests that advanced paternal age increases the risk of musculoskeletal congenital anomalies (CAs) in offspring, but findings are inconsistent. This study aims to investigate the risk of musculoskeletal CAs according to paternal age at birth in an unselected population covering cohort of children. STUDY DESIGN A register-based prospective study of 1,605,885 children born in Denmark, 1978-2004, using information from record-linked health and administrative registers. The association between paternal age and overall musculoskeletal CAs, limb anomalies, craniosynostosis, skeletal dysplasias, syndromic musculoskeletal CAs, and other musculoskeletal CAs were investigated by multiple logistic regression analysis. RESULTS For overall musculoskeletal CAs, a slightly higher risk per 10-year increase in paternal age was found (odds ratio [OR] = 1.06 [95% CI: 1.01-1.11; where CI is confidence interval]). A 26% (95% CI: 2-56%) excess risk was found for fathers aged 50+ years compared to fathers aged 30-34 years. For syndromic musculoskeletal CAs, excess risks were found for fathers aged 40+ years, compared to fathers aged 30-34 years (40-44: OR = 1.38 [95% CI: 1.01-1.88], 45-49: OR = 1.45 [95% CI: 0.89-2.34], 50+: OR = 1.42 [95% CI: 0.73-2.79]). The risks in all other subgroups of musculoskeletal CAs were increased for fathers aged 50+ years. CONCLUSIONS A slightly higher risk for overall musculoskeletal CAs in offspring was found with increasing paternal age, mainly due to an excess risk of syndromic musculoskeletal CAs for fathers aged 40+ years. While associations between paternal age 50+ years and increased risk of all subtypes of musculoskeletal CAs were indicated, advanced paternal age likely plays a minor role in the etiology of these anomalies.
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Affiliation(s)
- Stine Kjaer Urhoj
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
| | - Laust Hvas Mortensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
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Forster P, Hohoff C, Dunkelmann B, Schürenkamp M, Pfeiffer H, Neuhuber F, Brinkmann B. Elevated germline mutation rate in teenage fathers. Proc Biol Sci 2015; 282:20142898. [PMID: 25694621 PMCID: PMC4345458 DOI: 10.1098/rspb.2014.2898] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Men age and die, while cells in their germline are programmed to be immortal. To elucidate how germ cells maintain viable DNA despite increasing parental age, we analysed DNA from 24 097 parents and their children, from Europe, the Middle East and Africa. We chose repetitive microsatellite DNA that mutates (unlike point mutations) only as a result of cellular replication, providing us with a natural ‘cell-cycle counter’. We observe, as expected, that the overall mutation rate for fathers is seven times higher than for mothers. Also as expected, mothers have a low and lifelong constant DNA mutation rate. Surprisingly, however, we discover that (i) teenage fathers already set out from a much higher mutation rate than teenage mothers (potentially equivalent to 77–196 male germline cell divisions by puberty); and (ii) ageing men maintain sperm DNA quality similar to that of teenagers, presumably by using fresh batches of stem cells known as ‘A-dark spermatogonia’.
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Affiliation(s)
- Peter Forster
- Institute for Forensic Genetics, Münster 48161, Germany Murray Edwards College, University of Cambridge, Cambridge CB3 0DF, UK
| | | | - Bettina Dunkelmann
- Institute of Legal Medicine, University of Salzburg, Ignaz-Harrer-Strasse 79, Salzburg 5020, Austria
| | | | - Heidi Pfeiffer
- Institute of Legal Medicine, University of Münster, Münster 48149, Germany
| | - Franz Neuhuber
- Institute of Legal Medicine, University of Salzburg, Ignaz-Harrer-Strasse 79, Salzburg 5020, Austria
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Wijers CHW, van Rooij IALM, Marcelis CLM, Brunner HG, de Blaauw I, Roeleveld N. Genetic and nongenetic etiology of nonsyndromic anorectal malformations: a systematic review. ACTA ACUST UNITED AC 2015; 102:382-400. [PMID: 25546370 DOI: 10.1002/bdrc.21068] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 08/06/2014] [Indexed: 12/12/2022]
Abstract
Congenital anorectal malformations (ARMs) are one of the most frequently observed birth defects of the digestive system. However, their etiology remains elusive. Therefore, we aim to summarize and critically appraise all existing literature on the genetic and nongenetic etiology of nonsyndromic ARM and to conclude with unifying hypotheses and directions for future research. A structured literature search on English language human studies was conducted in PubMed and Embase up to October 1, 2013, resulting in 112 included articles. Research on the identification of genes underlying nonsyndromic ARM is remarkably scarce. Most studies were focused on screening of candidate genes for mutations or single-nucleotide polymorphisms, which did not yield any substantial evidence. Nongenetic factors fairly consistently found to be associated with ARM are assisted reproductive techniques, multiple pregnancy, preterm delivery, low birth weight, maternal overweight or obesity, and preexisting diabetes. This review provides indications for the involvement of both genes and nongenetic risk factors in the etiology of ARM. In future studies, large cohorts of patients with ARM from national and international collaborations are needed to acquire new hypotheses and knowledge through hypothesis-generating approaches. Challenges for future studies may also lie in the investigation of gene-gene and gene-environment interactions.
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Affiliation(s)
- Charlotte H W Wijers
- Department for Health Evidence, Radboud university medical center, Nijmegen, The Netherlands
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Bupp CP, Sarasua SM, Dean JH, Stevenson RE. When folic acid fails: Insights from 20 years of neural tube defect surveillance in South Carolina. Am J Med Genet A 2015; 167A:2244-50. [PMID: 26108864 DOI: 10.1002/ajmg.a.37168] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 05/03/2015] [Indexed: 12/31/2022]
Abstract
Neural tube defects (NTDs) are the most common of the severe malformations of the brain and spinal cord. Increased maternal intake of folic acid (FA) during the periconceptional period is known to reduce NTD risk. Data from 1046 NTD cases in South Carolina were gathered over 20 years of surveillance. It was possible to determine maternal periconceptional FA use in 615 NTD-affected pregnancies. In 163 occurrent (26.9%) and two recurrent (22%) NTD cases, the mothers reported periconceptional FA use. These women were older and more likely to be white. Maternal periconceptional FA usage was reported in 40.4% of cases of spina bifida with other anomalies but in only 25.2% of isolated spina bifida cases (P = 0.02). This enrichment for associated anomalies was not noted among cases of anencephaly or of encephalocele. Among the 563 subsequent pregnancies to mothers with previous NTD-affected pregnancies, those taking FA had a 0.4% NTD recurrence rate, but the recurrence without FA was 8.5%. NTDs with other associated findings were less likely to be prevented by FA, suggesting there is a background NTD rate that cannot be further reduced by FA. Nonetheless, the majority (73.9%) of NTDs in pregnancies in which the mothers reported periconceptional FA use were isolated NTDs of usual types. Cases in which FA failed in prevention of NTDs provide potential areas for further study into the causation of NTDs. The measures and techniques implemented in South Carolina can serve as an effective and successful model for prevention of NTD occurrence and recurrence.
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Affiliation(s)
- Caleb P Bupp
- Greenwood Genetic Center, Greenwood, South Carolina
| | | | - Jane H Dean
- Greenwood Genetic Center, Greenwood, South Carolina
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Su XJ, Yuan W, Huang GY, Olsen J, Li J. Paternal age and offspring congenital heart defects: a national cohort study. PLoS One 2015; 10:e0121030. [PMID: 25806788 PMCID: PMC4373953 DOI: 10.1371/journal.pone.0121030] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 02/08/2015] [Indexed: 01/06/2023] Open
Abstract
Paternal age has been associated with offspring congenital heart defects (CHDs), which might be caused by increased mutations in the germ cell line because of cumulated cell replications. Empirical evidences, however, remain inconclusive. Furthermore, it is unknown whether all subtypes of CHDs are affected by paternal age. We aimed to explore the relationship between paternal age and the risk of offspring CHDs and its five common subtypes using national register data in Denmark. A total of 1 893 899 singletons born in Denmark from 1977 to 2008 were included in this national-based cohort study. Cox’s proportion hazards model with robust sandwich estimate option was used to estimate the hazards ratio (95% confidence interval) for the associations between paternal age and all CHDs, as well as subtypes of CHDs (patent ductus arteriosus (PDA), ventricular septal defect (VSD), atrial septal defect (ASD), tetralogy of fallot (TOF) and coarctation of the aorta (CoA)). We did not observe an overall association between paternal age and offspring CHDs. However, compared to the paternal age of 25–29 years, paternal age of older than 45 years was associated with a 69% increased risk of PDA (HR45+ = 1.69, 95%CI:1.17–2.43). We observed similar results when subanalyses were restricted to children born to mothers of 27–30 years old. After taking into consideration of maternal age, our data suggested that advanced paternal age was associated with an increased prevalence of one subtype of offspring congenital heart defects (CHDs), namely patent ductus arteriosus (PDA).
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Affiliation(s)
- Xiu Juan Su
- Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
- Section for Epidemiology, Department of Public health, Aarhus University, Aarhus, Denmark
- * E-mail: (XJS); (WY)
| | - Wei Yuan
- NPFPC Laboratory of Contraception and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China
- Institute of Reproduction and Development, Fudan University, Shanghai, China
- * E-mail: (XJS); (WY)
| | - Guo Ying Huang
- Children‘s Hospital of Fudan University, Shanghai, China
| | - Jørn Olsen
- Section for Epidemiology, Department of Public health, Aarhus University, Aarhus, Denmark
| | - Jiong Li
- Section for Epidemiology, Department of Public health, Aarhus University, Aarhus, Denmark
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Paternal Factors Associated with Neonatal Deaths and Births with Low Weight: Evidence from Pakistan Demographic and Health Survey 2006–2007. Matern Child Health J 2015; 19:1634-42. [DOI: 10.1007/s10995-015-1674-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Johnson SL, Dunleavy J, Gemmell NJ, Nakagawa S. Consistent age-dependent declines in human semen quality: a systematic review and meta-analysis. Ageing Res Rev 2015; 19:22-33. [PMID: 25462195 DOI: 10.1016/j.arr.2014.10.007] [Citation(s) in RCA: 214] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 10/24/2014] [Accepted: 10/27/2014] [Indexed: 12/12/2022]
Abstract
Reduced fertility typically occurs among women in their late 30s, but increasing evidence indicates that advanced paternal age is associated with changes in reproduction as well. Numerous studies have investigated age-based declines in semen traits, but the impact of paternal age on semen parameter values remains inconclusive. Using data from 90 studies (93,839 subjects), we conducted a systematic review and meta-analysis to quantify the effect of male age on seven ejaculate traits (semen volume, sperm concentration, total sperm count, morphology, total motility, progressive motility and DNA fragmentation). Age-associated declines in semen volume, percentage motility, progressive motility, normal morphology and unfragmented cells were statistically significant and results generally seemed to be robust against confounding factors. Unexpectedly, sperm concentration did not decline with increasing male age, even though we found that sperm concentration declined over time. Our findings indicate that male age needs more recognition as a potential contributor to the negative pregnancy outcomes and reduced offspring health associated with delayed first reproduction. We suggest that greater focus on collection of DNA fragmentation and progressive motility in a clinical setting may lead to better patient outcomes during fertility treatments of aging couples.
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Affiliation(s)
- Sheri L Johnson
- Department of Anatomy, University of Otago, Dunedin 9054, New Zealand; Department of Zoology, University of Otago, Dunedin 9054, New Zealand; Allan Wilson Centre, University of Otago, Dunedin 9054, New Zealand.
| | - Jessica Dunleavy
- Department of Anatomy, University of Otago, Dunedin 9054, New Zealand
| | - Neil J Gemmell
- Department of Anatomy, University of Otago, Dunedin 9054, New Zealand; Allan Wilson Centre, University of Otago, Dunedin 9054, New Zealand; Gravida: National Centre for Growth and Development, University of Otago, Dunedin 9054, New Zealand
| | - Shinichi Nakagawa
- Department of Zoology, University of Otago, Dunedin 9054, New Zealand; Gravida: National Centre for Growth and Development, University of Otago, Dunedin 9054, New Zealand
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