Sunday, February 24, 2008

Miscarriage significantly associated with increasing paternal age

Women with partners aged 35 or older had nearly three times as many miscarriages as compared with women conceiving with men younger than 25 years of age. This finding is independent of the woman's age and not explained by other factors such as diabetes, smoking, or previous spontaneous abortions, and adds to the growing realization of the importance of paternal characteristics for successful reproductive outcome.


Obstetrics & Gynecology 2006;108:369-377 © 2006 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH
Paternal Age and Spontaneous Abortion K. Kleinhaus, MD, MPH1, M. Perrin, DrPH1, Y. Friedlander, PhD2, O. Paltiel, MDCM, MSc2,3, D. Malaspina, MD, MPH4,5 and S. Harlap, MB1
From the 1Mailman School of Public Health, Columbia University, New York, New York; 2Braun School of Public Health and Community Medicine and 3Department of Hematology, Hadassah-Hebrew University, Jerusalem, Israel; 4Department of Psychiatry, Columbia University, New York, New York; and 5New York State Psychiatric Institute, New York, New York.
OBJECTIVE: To evaluate the influence of paternal age upon spontaneous abortion.
METHODS: This case–control study of 13,865 women draws on data from women's antenatal or postpartum interviews in the Jerusalem Perinatal Study, a population-based cohort derived from 92,408 births in 1964–1976. Case women (n=1,506) reported spontaneous abortion in the pregnancy preceding the interview; they were compared with women reporting live births in their previous pregnancy (n=12,359). Logistic regression was used to adjust for maternal age, maternal diabetes, maternal smoking, history of spontaneous abortions before the index pregnancy, parity at interview, and interval between the index pregnancy and the interview.
RESULTS: The adjusted odds ratio for spontaneous abortion was 0.59 (95% confidence interval 0.45–0.76, P< .0001) for pregnancies conceived from fathers aged younger than 25 years compared with those from fathers aged 25–29 years. For fathers age 40 years or older the odds ratio for spontaneous abortion was 1.6 (95% confidence interval 1.2–2.0, P=.0003) when compared with the same reference group.
CONCLUSION: Increasing paternal age is significantly associated with spontaneous abortion, independent of maternal age and multiple other factors.
LEVEL OF EVIDENCE: II-2

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