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Parental age and age gap in relation to neonatal health: a cohort study in eastern China
Xuezhi Zhao1, Siyuan Qian2, Yongran Cheng3
1Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Insights
Advanced parental age increases neonatal disease risk, particularly for mothers over 30 and fathers over 40. This highlights the need to consider combined parental ages in preconception counseling and risk assessments.
Area of Science:
- Reproductive Health
- Perinatal Epidemiology
- Neonatal Outcomes
Background:
- Parental age and age gaps are increasingly recognized as factors influencing pregnancy and neonatal health.
- Understanding these associations is crucial for effective preconception counseling and risk stratification.
Purpose of the Study:
- To investigate the association between parental age, age gap, and neonatal health outcomes.
- To provide epidemiological evidence for preconception counseling and perinatal risk assessment.
Main Methods:
- Retrospective cohort study of 15,762 mother-infant pairs.
- Multivariable logistic regression to analyze parental age comparison and neonatal diseases.
- Adjustment for confounders including maternal BMI, hypertension, diabetes, gestational week, smoking, alcohol use, and education.
- Restricted cubic splines to assess nonlinear dose-response relationships.
Main Results:
- Both mother-older and father-older groups showed increased odds of neonatal diseases compared to equal-age parents.
- Maternal age (OR=1.080) and paternal age (OR=1.051) were independent risk factors.
- Risk accelerated after maternal age >30.1 years and paternal age >40.2 years.
- Significant interactions observed between age gap and maternal age, and between maternal and paternal ages.
Conclusions:
- Both maternal and paternal ages are independent risk factors for adverse neonatal outcomes.
- Nonlinear dose-response relationships exist, with risks increasing significantly after certain age thresholds.
- The combined parental age structure is essential for preconception counseling and perinatal risk assessment.
Objective:
To investigate the association between parental age, age gap, and neonatal health outcomes, and to provide epidemiological evidence for preconception counseling and perinatal risk assessment.
Methods:
This retrospective cohort study included mother-infant pairs who delivered at the Women's Hospital, Zhejiang University School of Medicine between January 2016 and December 2022. A total of 15,762 pairs were analyzed, comprising 7,557 healthy controls and 8,205 cases. The primary exposure was parental age comparison. Multivariable logistic regression was used to examine the association between parental age comparison and neonatal diseases, with adjustment for maternal BMI, hypertension, diabetes, gestational week, smoking, alcohol use, and educational level. Parental ages were also entered as continuous variables, and interaction terms were tested. Restricted cubic splines were applied to assess nonlinear dose-response relationships.
Results:
Compared with the equal-age group, both the father-older group (OR = 1.561, 95% CI: 1.203-3.201) and the mother-older group (OR = 1.652, 95% CI: 1.323-2.343) had significantly increased odds of neonatal diseases. After further adjustment for individual parental ages, the father-older association became non-significant (OR = 1.121, P = 0.420), while the mother-older association remained marginally significant (OR = 1.012, P = 0.022). Both maternal age (OR = 1.080, P < 0.001) and paternal age (OR = 1.051, P = 0.002) were independent risk factors. Significant interactions were observed between age gap and maternal age (OR = 1.098, P = 0.011) and between maternal and paternal ages (OR = 1.098, P = 0.032). Restricted cubic spline analysis showed that the risk of adverse neonatal outcomes accelerated after maternal age >30.1 years and paternal age >40.2 years (nonlinear P < 0.01 for both).
Conclusion:
Both maternal and paternal ages are independent risk factors with nonlinear dose-response relationships. The combined structure of parental ages should be considered in preconception counseling and perinatal risk assessment.
