Delayed childbearing: effects on fertility and the outcome of pregnancy.

Curr Opin Obstet Gynecol. 2012 Mar 23. [Epub ahead of print]

Delayed childbearing: effects on fertility and the outcome of pregnancy.

Source

aInstitut Clínic of Gynecology, Obstetrics and Neonatology, Hospital ClínicInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine-University of Barcelona bCentro de Investigación en Red para la Investigación de Enfermedades Raras (CIBER-ER), Barcelona, Spain.

Abstract

PURPOSE OF REVIEW:

The proportion of women who are intentionally delaying pregnancy beyond the age of 35 years has increased greatly in the past few decades because of the clash between the optimal biological period for women to have children with obtaining additional education and building a career. This article highlights the effects of delayed childbearing on fertility and obstetric and perinatal outcome.

RECENT FINDINGS:

Demographic studies indicate that fertility rates are falling in many countries, Europe being the continent with lowest total fertility rate. Female employment and childrearing can be combined when the reduction in work-family conflict is facilitated by state of policy intervention. It has been traditionally accepted that fertility is more related to the age of the female than the male partner but recent literature suggests trends that increased paternal age is also associated with lower fertility, an increase in pregnancy-associated complications and an increase in adverse outcome in the offspring. Delayed childbearing is rarely a conscious choice and women are unaware that, at present, with the exception of egg donation, assisted reproductive technology has no answer yet to age-related decline of female fertility. There is no evidence of a beneficial effect of preimplantation genetic screening for women of advanced maternal age. Concerning perinatal outcomes, apart from the known effects of advanced maternal age on common fetal and obstetric complications, recent evidence increasingly points toward an independent association between maternal (and paternal age) and cerebral palsy, neurocognitive and psychiatric disorders.

SUMMARY:

The consequences of advancing maternal and paternal age are not only relevant for the risk of natural and assisted conception, but also for the outcome of pregnancy. Although the absolute rate of poor pregnancy outcomes may be low from an individual standpoint, the impact of delaying childbearing from a public health perspective cannot be overestimated and should be in the agenda of public health policies for the years to come.

PMID:: 22450043; [PubMed - as supplied by publisher]

Fertility clock ticks for men, too

Julia Medew March 26, 2012

MEN are being urged to pay more attention to their biological clocks as research shows those aged over 40 are at higher risk of having a child with autism and birth defects.
As the average age of Australian fathers continues to increase, reproductive health experts are calling for men to learn more about their fertility and the risks of older fatherhood.
Dr Karin Hammarberg, a researcher with the Victorian Assisted Reproductive Treatment Authority (VARTA), said that while most children are born healthy, large studies of parental age were starting to show higher rates of birth defects and autism in children born to men over 40.
A recent review of paternal age published in the Asian Journal of Andrology said an American study of 132,000 men found children of those over 45 were nearly six times more likely to have an autism spectrum disorder compared to children born to men under 30.
The review also pointed to a Dutch study of 60,000 births which found children born to men over 40 were three times more likely to have autism and a US study of 5 million births which showed men over 50 had a 15 per cent higher chance of having a baby with birth defects including congenital heart disease and cleft palates.
Dr Hammarberg said research also showed men over 40 had much more trouble getting a woman pregnant and the rate of miscarriage doubled for women when their partner was over 45. The average time to pregnancy for men under 25 is just over 4.5 months but nearly two years for men over 40.
"Fertility talk is always directed at women and somehow men look like innocent bystanders," she said.
"Men really need to know that their own age and health will affect their fertility, too."
Between 1990 and 2010, the median age of Australian fathers increased from 31 to 34 while more men in their late 50s and early 60s were becoming fathers. In 2010, 777 men aged 55 to 59 fathered a child, up from 674 in 2004 and 516 in 2000. The number of men in their 60s having babies has also increased from 226 in 2000 to 408 in 2010.
The Fertility Coalition, made up of VARTA, Andrology Australia, Jean Hailes for Women's Health and the Robinson Institute, will launch a website today to teach Australians about fertility. See yourfertility.org.au

Advanced paternal age increases the risk of schizophrenia and obsessive-compulsive disorder in a Chinese Han population.

Psychiatry Res. 2012 Mar 16. [Epub ahead of print]

Advanced paternal age increases the risk of schizophrenia and obsessive-compulsive disorder in a Chinese Han population.

Wu Y, Liu X, Luo H, Deng W, Zhao G, Wang Q, Zhang L, Ma X, Liu X, Murray RA, Collier DA, Li T.

Source

The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.

Abstract

Using the Structured Clinical Interview for DSM-IV, patient and non-patient version (SCID-P/NP), this study investigated 351 patients with schizophrenia, 122 with obsessive-compulsive disorder (OCD), and 238 unrelated healthy volunteers in a Chinese Han population. The relative risks effected by advanced paternal age for schizophrenia and OCD in offspring were computed under logistic regression analyses and adjusted for the participant's sex, age and co-parent age at birth. Compared to the offspring with paternal age of 25-29years old, the relative risks rose from 2.660 to 10.183 in paternal age range of 30-34 and ≥35. The relative risks for OCD increased from 2.225 to 5.413 in 30-34 and ≥35. For offspring with paternal age of <25, the odds ratios of developing schizophrenia and OCD were 0.628 and 0.289 respectively, whereas, an association between increased maternal age and risk for schizophrenia/OCD was not seen. Interaction analysis showed an interaction effect between paternal age and maternal age at birth. Such a tendency of risk affected by parental age for schizophrenia and OCD existed after splitting out the data of early onset patients. Sex-specific analyses found that the relative risks for schizophrenia with paternal age of 30-34 and ≥35 in male offspring were 2.407 and 10.893, in female were 3.080 and 9.659. The relative risks for OCD with paternal age of 30-34 and ≥35 in male offspring were 3.493 and 7.373, and in female offspring 2.005 and 4.404. The mean paternal age of schizophrenia/OCD patients born before the early 1980s was much greater than that of patients who were born after then. The findings illustrated that advanced paternal age is associated with increased risk for both schizophrenia and OCD in a Chinese Han population, prominently when paternal age is over 35. Biological and non-biological mechanisms may both be involved in the effects of advanced paternal age on schizophrenia and OCD.
Copyright Â© 2012. Published by Elsevier Ireland Ltd.

the association with high paternal age

Am J Med Genet A. 2012 Mar 9. doi: 10.1002/ajmg.a.35246. [Epub ahead of print]

Clinical epidemiology of skeletal dysplasias in South America.

Barbosa-Buck CO, Orioli IM, da Graça Dutra M, Lopez-Camelo J, Castilla EE, Cavalcanti DP.

Source

Faculdade de Ciências Médicas, Departamento de Genética Médica, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil.

Abstract

Currently accepted birth prevalence for osteochondrodysplasias (OCD) of about 2/10,000 is based on few studies from small series of cases. We conducted a study based on more than 1.5 million births. OCD cases were detected from 1,544,496 births occurring and examined in 132 hospitals of ECLAMC (Latin American Collaborative Study of Congenital Malformations) between 2000 and 2007. Cases were detected and registered according to a pre-established protocol, and then ranked in four diagnostic evidence levels (DEL), according to available documentation. For the analysis of risk factors, a healthy control sample born in the same period was used. OCD was diagnosed in 492 newborns, resulting in a prevalence per 10,000 of 3.2 (95% CI: 2.9-3.5). Perinatal lethality (stillbirths plus early neonatal deaths) occurred in 50% of cases. Prenatal ultrasound diagnosis was made in 73% of cases (n = 359). Among 211 cases from the best documented group (DEL-1) and according to international classification, 33% of cases fit into the G-25 (osteogenesis imperfecta), 29% in Group-1 (FGFR3), and 8% in Group-18 (Bent bones). The prevalence of the main OCD types were: OI-0.74 (0.61-0.89); thanatophoric dysplasia-0.47 (0.36-0.59); and achondroplasia-0.44 (0.33-0.55). Paternal age (31.2 ± 8.5), parity (2.6), and parental consanguinity rate (5.4%) were higher in cases than in controls (P < 0.001). In conclusion, the OCD overall prevalence of 3.2 per 10,000 found seems to be more realistic than previous estimates. This study also confirmed the high perinatal mortality, and the association with high paternal age, parity, and parental consanguinity rate. © 2012 Wiley Periodicals, Inc.

High frequencies of de novo CNVs in bipolar disorder and schizophrenia.

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Neuron. 2011 Dec 22;72(6):951-63.

High frequencies of de novo CNVs in bipolar disorder and schizophrenia.

Source

Beyster Center for Genomics of Psychiatric Diseases, University of California, San Diego, La Jolla, CA 92093, USA.

Abstract

While it is known that rare copy-number variants (CNVs) contribute to risk for some neuropsychiatric disorders, the role of CNVs in bipolar disorder is unclear. Here, we reasoned that a contribution of CNVs to mood disorders might be most evident for de novo mutations. We performed a genome-wide analysis of de novo CNVs in a cohort of 788 trios. Diagnoses of offspring included bipolar disorder (n = 185), schizophrenia (n = 177), and healthy controls (n = 426). Frequencies of de novo CNVs were significantly higher in bipolar disorder as compared with controls (OR = 4.8 [1.4,16.0], p = 0.009). De novo CNVs were particularly enriched among cases with an age at onset younger than 18 (OR = 6.3 [1.7,22.6], p = 0.006). We also confirmed a significant enrichment of de novo CNVs in schizophrenia (OR = 5.0 [1.5,16.8], p = 0.007). Our results suggest that rare spontaneous mutations are an important contributor to risk for bipolar disorder and other major neuropsychiatric diseases.
Copyright © 2011 Elsevier Inc. All rights reserved.

Paternal Age Effect: How Old is Too Old?

Wednesday, March 28, 2012