Jonathan A Mayo1, Ying Lu2, David K Stevenson3, Gary M Shaw3, Michael L Eisenberg4. 1. March of Dimes Prematurity Research Center, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA. Electronic address: jmayo@stanford.edu. 2. Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA. 3. March of Dimes Prematurity Research Center, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA. 4. Departments of Urology and Obstetrics/Gynecology, Stanford University School of Medicine, Stanford, CA.
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.
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.
Authors: Patricia L Weng; Amar J Majmundar; Kamal Khan; Tze Y Lim; Shirlee Shril; Gina Jin; John Musgrove; Minxian Wang; Dina F Ahram; Vimla S Aggarwal; Louise E Bier; Erin L Heinzen; Ana C Onuchic-Whitford; Nina Mann; Florian Buerger; Ronen Schneider; Konstantin Deutsch; Thomas M Kitzler; Verena Klämbt; Amy Kolb; Youying Mao; Christelle Moufawad El Achkar; Adele Mitrotti; Jeremiah Martino; Bodo B Beck; Janine Altmüller; Marcus R Benz; Shoji Yano; Mohamad A Mikati; Talha Gunduz; Heidi Cope; Vandana Shashi; Howard Trachtman; Monica Bodria; Gianluca Caridi; Isabella Pisani; Enrico Fiaccadori; Asmaa S AbuMaziad; Julian A Martinez-Agosto; Ora Yadin; Jonathan Zuckerman; Arang Kim; Ulrike John-Kroegel; Amanda V Tyndall; Jillian S Parboosingh; A Micheil Innes; Agnieszka Bierzynska; Ania B Koziell; Mordi Muorah; Moin A Saleem; Julia Hoefele; Korbinian M Riedhammer; Ali G Gharavi; Vaidehi Jobanputra; Emma Pierce-Hoffman; Eleanor G Seaby; Anne O'Donnell-Luria; Heidi L Rehm; Shrikant Mane; Vivette D D'Agati; Martin R Pollak; Gian Marco Ghiggeri; Richard P Lifton; David B Goldstein; Erica E Davis; Friedhelm Hildebrandt; Simone Sanna-Cherchi Journal: Am J Hum Genet Date: 2021-01-27 Impact factor: 11.025
Authors: David K Stevenson; Ronald J Wong; Nima Aghaeepour; Ivana Maric; Martin S Angst; Kevin Contrepois; Gary L Darmstadt; Maurice L Druzin; Michael L Eisenberg; Brice Gaudilliere; Ronald S Gibbs; Ian H Gotlib; Jeffrey B Gould; Henry C Lee; Xuefeng B Ling; Jonathan A Mayo; Mira N Moufarrej; Cecele C Quaintance; Stephen R Quake; David A Relman; Marina Sirota; Michael P Snyder; Karl G Sylvester; Shiying Hao; Paul H Wise; Gary M Shaw; Michael Katz Journal: Pediatr Res Date: 2020-05-26 Impact factor: 3.756