Parental Age and Childhood Risk for Cerebral Palsy in California

Area of Science:

• Reproductive health
• Pediatric neurology
• Epidemiology

Background:

• Parental age is a known factor influencing pregnancy outcomes.
• Cerebral palsy (CP) is a complex neurological disorder with multifactorial causes.
• Previous studies have explored links between parental age and CP, but findings require further population-based validation.

Purpose of the Study:

• To investigate the association between maternal and paternal age at delivery and the risk of cerebral palsy (CP) in offspring.
• To explore the mediating role of preterm delivery in the relationship between parental age and CP risk.

Main Methods:

• Population-based case-control study utilizing California birth records (1994-2010).
• Included 8,736 singleton CP cases and 90,250 singleton controls, matched by sex and birth year.
• Causal mediation analysis was employed to assess direct and indirect effects of parental age on CP, with preterm delivery as a mediator.

Main Results:

• Children born to mothers ≤19 years or 35-39 years, and ≥40 years, showed increased CP risk compared to mothers aged 25-29 years.
• Advanced paternal age (40-44 years; ≥45 years) was associated with higher CP risk, independent of maternal age.
• The highest CP risk was observed when both parents were older (≥35 years).
• Preterm birth mediated 19%-34% of the association between parental age and offspring CP risk.

Conclusions:

• Young maternal age and advanced parental age (either or both parents) are linked to increased offspring cerebral palsy risk.
• While preterm birth is a significant mediator, other age-related factors warrant further investigation to fully understand CP etiology.