Association between maternal age and birth defects of unknown etiology ― United States, 1997–2007

Gill, Simerpal K.; Broussard, Cheryl S.; Devine, Owen; Green, Ridgely Fisk; Rasmussen, Sonja A.; Reefhuis, Jennita

doi:10.1002/bdra.23049

Cited by 134 publications

(99 citation statements)

References 55 publications

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“…This result was in accordance with many other studies 13–15,37,40–42. According to Gill et al,17 increased risks for several cardiac defects, including ventricular septal defects, atrial septal defects, and Tetralogy of Fallot, were observed for mothers who were 40+ years of age. In the present study, a U-shaped maternal age effect on congenital malformations of the aortic and mitral valves was observed.…”

Section: Discussionsupporting

confidence: 91%

“…They found that all birth defects combined and all nonchromosomal birth defects showed increased odds ratios for young and advanced maternal age, with a more pronounced increase for the group that included chromosomal defects. Overall, the relationship between maternal age and the prevalence of birth defects per birth or per live birth was similar in many previous studies in that these studies showed U-curves or gradual J-curves for nonchromosomal birth defects and extreme J-curves for chromosomal abnormalities 11–17. The present results also support previous findings that the effect of advanced maternal age, especially over 40, on nonchromosomal birth defects was not large compared to the effect on chromosomal abnormalities.…”

Section: Discussionsupporting

confidence: 91%

“…Several studies found an effect of maternal age on the nervous system,12,16 specifically on neural tube defects8,35–37 such as spina bifida,14,17 anencephalus,16 and encephalocele 16. The risk of congenital malformations of the nervous system per pregnancy was significantly lower with advanced maternal age.…”

Section: Discussionmentioning

confidence: 99%

“…Both lower and higher maternal age may pose increased risks for birth defects 11–18. For example, older mothers have a higher risk of chromosomal abnormalities,19–22 such as Down syndrome,23–25 but whether they are at excess risk of nonchromosomal birth defects is less clear 17. It is important to have accurate information on maternal age-specific risks of birth defects after ART to gauge the implications of this rise in maternal age for public health, to gauge clinical care needs, and to provide information to couples of childbearing age 16…”

Section: Introductionmentioning

confidence: 99%

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Maternal age and birth defects after the use of assisted reproductive technology in Japan, 2004–2010

Ooki¹

2013

IJWH

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BackgroundOlder mothers are becoming more common in Japan. One reason for this is the widespread use of assisted reproductive technology (ART). This study assesses the relationship between maternal age and the risk of birth defects after ART.MethodsNationwide data on ART between 2004 and 2010 in Japan were analyzed. Diseases that were classified as code Q00-Q99 (ie, congenital malformations, deformations, and chromosomal abnormalities) in the International Classification of Diseases, tenth edition, were selected. There were 219,185 pregnancies and 153,791 live births in total ART. Of these, 1943 abortions, stillbirths, or live births with birth defects were recorded. Percentage of multiple birth defects in total birth defects, the prevalence, crude relative risk and 95% confidence interval per 10,000 pregnancies and per 10,000 live births were analyzed according to the maternal age class (ie, 25–29, 30–34 (reference), 35–39, and 40+ years).ResultsMultiple birth defects were observed among 14% of the 25–29 year old class, and 8% among other classes when chromosomal abnormalities were excluded. The prevalence of chromosomal abnormalities per pregnancy and per live birth became significantly and rapidly higher in mothers in the age classes of 30–35 and 40+ years. Nonchromosomal birth defects per pregnancy decreased linearly with advanced maternal age, while the number of nonchromosomal birth defects per live birth formed a gradual U-shaped distribution. The prevalence per pregnancy of congenital malformations of the nervous system was significantly lower with advanced maternal age. The relative risk per live birth was significant regarding congenital malformations of the circulatory system for a maternal age of 40+ years. Some other significant associations between maternal age and birth defects were observed.ConclusionMaternal age is associated with several birth defects; however, older maternal age in itself does not produce noticeable extra risk for nonchromosomal birth defects overall.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternal age and birth defects after the use of assisted reproductive technology in Japan, 2004–2010

Ooki¹

2013

IJWH

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“…Data from the National Birth Defects Prevention Study (NBDPS), which includes the states of Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas, and Utah, revealed that mothers ≥35 years were 2.1 times more likely to have a newborn with hypospadias than women <25 years of age (OR: 2.1, 95% CI: 1.5-2.8) between the years of 1997 to 2000 [11]. Another study that employed the NBDPS database, a positive association was found for advanced maternal age (> 40 years) and hypospadias between the years of 1997 to 2007 (OR: 2.0, 95% CI: 1.4-3.0) [12]. In Puerto Rico, data from the Birth Defects Prevention and Surveillance System of the Department of Health of Puerto Rico (2007 – 10) revealed an OR of 2.77 (95% CI: 1.26-6.13) for > 40 years old mothers [13].…”

Section: Discussionmentioning

confidence: 99%

Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Jorge¹,

Perez-Brayfield

Torres

et al. 2016

JURNOA

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Background & Objectives Hypospadias is characterized by a displacement of the urethral opening in males that can change from the typical position within the glans penis to a subcoronal position (Type I), to anywhere along the ventral shaft (Type II), to penoscrotal, scrotal, or perineal positions (Type III). We and others have previously reported that age of the mother (≥ 40 years old) is a risk factor for having a child with hypospadias, but there is a scarcity of reports on whether such risk is higher for having a child with the mild (Type I) or the more severe forms (Types II and III). In addition, we aimed to assess the timing of hypospadias repair according to severity. Methods Parents of children with hypospadias were interviewed by using a series of questionnaires (n = 128 cases). Severity was confirmed in the clinic and age of the mother was self-reported. Number of surgeries, age of child by the first and the last intervention was also assessed. Ordered logistic regression and the Brant test were employed to calculate risk between mild (Type I) and severe cases (Types II and III), and the assumption of proportional odds, respectively. The Mann-Whitney U Test was used to compare number of surgeries and age by the last repair between mild and severe cases. One-way ANOVA was employed to compare age of the child at the time of first surgery across severities (Types I - III). Results Women ≥ 40 years of age are 3.89 times [95% CI: 1.20-12.64] at a higher risk for having a child with the more severe forms of the condition than younger women. Repair of Type I was accomplished with 1 intervention whereas more severe cases required 1 – 4 (2 ± 0.5) surgical interventions. The timing for hypospadias repair of Type I cases occurred at an average age of 16.2 ± 4.88 months, of Type II cases occurred at an average age of 20.3 ± 8.15 months whereas the average age of the first hypospadias repair among Type III cases was 12.68 ± 2.52 months. Number of surgeries according to severity (p ≤ 0.0018, z-ratio = 2.91) and age difference for the timing of last repair (p ≤ 0.045, z-ratio = 1.69) were statistically different, but not the age difference for the first repair. Conclusions Increased maternal age is associated with the most severe forms of hypospadias. There is room for improvement for the timing of hypospadias repair according to severity.

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Association Between Prenatal Alcohol Exposure and Craniofacial Shape of Children at 12 Months of Age

et al. 2017

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IMPORTANCEChildren who receive a diagnosis of fetal alcohol spectrum disorder may have a characteristic facial appearance in addition to neurodevelopmental impairment. It is not well understood whether there is a gradient of facial characteristics of children who did not receive a diagnosis of fetal alcohol spectrum disorder but who were exposed to a range of common drinking patterns during pregnancy.OBJECTIVE To examine the association between dose, frequency, and timing of prenatal alcohol exposure and craniofacial phenotype in 12-month-old children. DESIGN, SETTING, AND PARTICIPANTSA prospective cohort study was performed from January 1, 2011, to December 30, 2014, among mothers recruited in the first trimester of pregnancy from low-risk, public maternity clinics in metropolitan Melbourne, Australia. A total of 415 white children were included in this analysis of 3-dimensional craniofacial images taken at 12 months of age. Analysis was performed with objective, holistic craniofacial phenotyping using dense surface models of the face and head. Partial least square regression models included covariates known to affect craniofacial shape.EXPOSURES Low, moderate to high, or binge-level alcohol exposure in the first trimester or throughout pregnancy.MAIN OUTCOMES AND MEASURES Anatomical differences in global and regional craniofacial shape between children of women who abstained from alcohol during pregnancy and children with varying levels of prenatal alcohol exposure. RESULTSOf the 415 children in the study (195 girls and 220 boys; mean [SD] age, 363.0 [8.3] days), a consistent association between craniofacial shape and prenatal alcohol exposure was observed at almost any level regardless of whether exposure occurred only in the first trimester or throughout pregnancy. Regions of difference were concentrated around the midface, nose, lips, and eyes. Directional visualization showed that these differences corresponded to general recession of the midface and superior displacement of the nose, especially the tip of the nose, indicating shortening of the nose and upturning of the nose tip. Differences were most pronounced between groups with no exposure and groups with low exposure in the first trimester (forehead), moderate to high exposure in the first trimester (eyes, midface, chin, and parietal region), and binge-level exposure in the first trimester (chin).CONCLUSIONS AND RELEVANCE Prenatal alcohol exposure, even at low levels, can influence craniofacial development. Although the clinical significance of these findings is yet to be determined, they support the conclusion that for women who are or may become pregnant, avoiding alcohol is the safest option.

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Association between maternal age and birth defects of unknown etiology ― United States, 1997–2007

Cited by 134 publications

References 55 publications

Maternal age and birth defects after the use of assisted reproductive technology in Japan, 2004–2010

Maternal age and birth defects after the use of assisted reproductive technology in Japan, 2004–2010

Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Association Between Prenatal Alcohol Exposure and Craniofacial Shape of Children at 12 Months of Age

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Association between maternal age and birth defects of unknown etiology ― United States, 1997–2007

Cited by 134 publications

References 55 publications

Maternal age and birth defects after the use of assisted reproductive technology in Japan, 2004&ndash;2010

Maternal age and birth defects after the use of assisted reproductive technology in Japan, 2004&ndash;2010

Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Association Between Prenatal Alcohol Exposure and Craniofacial Shape of Children at 12 Months of Age

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Maternal age and birth defects after the use of assisted reproductive technology in Japan, 2004–2010

Maternal age and birth defects after the use of assisted reproductive technology in Japan, 2004–2010