Maternal Age-Specific Risk of Nonchromosomal Anomalies

Abstract

Objectives To determine the excess risk of non-chromosomal congenital anomaly (NCA) among teenage mothers and older mothers.Design and setting Population-based prevalence study using data from EUROCAT congenital anomaly registers in 23 regions of Europe in 15 countries, covering a total of 1.75 million births from 2000 to 2004.Participants A total of 38 958 cases of NCA that were live births, fetal deaths with gestational age ‡20 weeks or terminations of pregnancy following prenatal diagnosis of a congenital anomaly.Main outcome measures Prevalence of NCA according to maternal age, and relative risk (RR) of NCA and 84 standard NCA subgroups compared with mothers aged 25-29. ResultsThe crude prevalence of all NCA was 26.5 per 1000 births in teenage mothers (<20 years), 23.8 for mothers 20-24 years, 22.5 for mothers 25-29 years, 21.5 for mothers 30-34 years, 21.4 for mothers 35-39 years and 22.6 for mothers 40-44 years. The RR adjusted for country for teenage mothers was 1.11 (95% CI 1.06-1.17); 0.99 (95% CI 0.96-1.02) for mothers 35-39; and 1.01 (95% CI 0.95-1.07) for mothers 40-44. The pattern of maternal age-related risk varied significantly between countries: France, Ireland and Portugal had higher RR for teenage mothers, Germany and Poland had higher RR for older mothers. The maternal age-specific RR varied for different NCAs. Teenage mothers were at a significantly greater risk (P < 0.01) of gastroschisis, maternal infection syndromes, tricuspid atresia, anencephalus, nervous system and digestive system anomalies while older mothers were at a significantly greater risk (P < 0.01) of fetal alcohol syndrome, encephalocele, oesophageal atresia and thanatophoric dwarfism.Conclusions Clinical and public health interventions are needed to reduce environmental risk factors for NCA, giving special attention to young mothers among whom some risk factors are more prevalent. Reassurance can be given to older mothers that their age in itself does not confer extra risk for NCA.

Epidemiology of septo-optic dysplasia with focus on prevalence and maternal age – A EUROCAT study

“…Our study also observed the association of lower maternal age and increased risk of septo-optic dysplasia, which has been noted in several studies (Elster andMcAnarney 1979, Lippe et al 1979 Murray et al 2005, Khaper et al 2017. There are only a few congenital anomalies that are associated with younger maternal age, with gastroschisis having the strongest association (Loane et al 2009). As we have shown for septo-optic dysplasia, the prevalence of gastroschisis is also higher in the UK compared to continental Europe (Loane et al 2007) and the aetiology is considered to be a result of a vascular disruption (van Gelder et al 2010).…”

“…This sensitively analysis was carried out as, from previous studies, it was expected that fetuses of younger mothers would have a higher risk of septooptic dysplasia (Elster and McAnarney 1979, Lippe 1979, Murray et al 2005, Atapattu et al 2012. This is unusual and the other main anomaly in which this age-related risk is seen is gastroschisis (Loane et al 2009). Gastroschisis has a high prevalence in younger mothers in the UK compared to the rest of Europe (Loane et al 2007).…”

EUROmediCAT signal detection: an evaluation of selected congenital anomaly‐medication associations

“…With the exception of chromosomal anomalies, most CAs are not strongly associated with maternal age [37]. However, gastroschisis, an abdominal wall defect, is associated with young maternal age [38] and it was necessary to adjust the gastroschisis-medication exposure association for maternal age.…”

Maternal age and prevalence of isolated congenital heart defects in an urban area of the United States

“…Furthermore, information on the variation in prevalence of specific CHD phenotypes with maternal age is limited by the inconsistency in the type of CHDs examined and the mixed results observed across studies. For example, while one investigator [Pradat et al, 2003] found a significant association between advanced maternal age and tetralogy of Fallot and atrioventricular septal defects (AVSDs), other investigators did not [Baird et al, 1991;O'Malley et al, 1996;Loane et al, 2009]. Furthermore, very few studies have been populationbased and have accounted for possible effect modifiers such as low birth weight (LBW), preterm delivery, maternal race, and infant sex.…”