Abstract：
The objective of the study was to explore the impact of paternal age on the risk of congenital anomalies and birth outcomes in infants born in the USA between 2016 and 2021. This retrospective cohort study used data from the National Vital Statistics System (NVSS) database, a data set containing information on live birth in the USA between 2016 and 2021. Newborns were divided into four groups based on their paternal age (< 25, 25-34, 35-44, and > 44 years) and using the 25-34 age group as a reference. The primary outcomes were congenital anomalies involving structural anomalies and chromosome anomalies. Secondary outcomes were preterm birth, low birth weight, severe neonatal perinatal asphyxia, and admission to neonatal intensive care units (NICU). A multivariable logistic regression model was used to analyze the association between paternal age and outcomes. Overall, 17,764,695 live births were included in the final analyses. After adjusting confounding factors, advanced paternal age > 44 years was associated with increased odds of congenital anomalies (adjusted odds ratio (aOR) = 1.17, 95%CI 1.12-1.21) compared with the 25-34 age group, mainly for the chromosomal anomalies (aOR = 1.59, 95%CI 1.40-1.78) but not the structure anomalies (aOR = 1.03, 95%CI 0.97-1.09). The risk of preterm delivery, low birth weight, and NICU hospitalization in their infants was increased by advanced parental age as well. Conclusion: Advanced paternal age increases the risk of congenital anomalies, especially chromosomal anomalies in their offspring, implying prenatal genetic counseling is required. What is Known: • There\'s a rising trend of advanced paternal age, which is associated with an increased likelihood of premature birth and low birth weight in their offspring. However, the exploration between paternal age and congenital abnormalities in offspring was limited and contradictory. What is New: • Infants with a paternal age > 44 years were more likely to be born with congenital anomalies, especially chromosomal anomalies.
摘要：
该研究的目的是探讨父亲年龄对2016年至2021年在美国出生的婴儿的先天性异常风险和出生结局的影响。这项回顾性队列研究使用了来自国家生命统计系统(NVSS)数据库的数据，包含2016年至2021年美国活产信息的数据集。根据其父系年龄（<25、25-34、35-44和>44岁）将新生儿分为四组，并以25-34岁年龄组为参考。主要结果是涉及结构异常和染色体异常的先天性异常。次要结局是早产，低出生体重,严重的新生儿围产期窒息，和入院新生儿重症监护病房（NICU）。使用多变量逻辑回归模型来分析父亲年龄与结局之间的关系。总的来说,最终分析中包括17,764,695例活产。在调整混杂因素后，与25-34年龄组相比，年龄>44岁的高龄患者与先天性异常的几率增加相关（校正比值比（aOR）=1.17，95CI1.12-1.21），主要为染色体异常（aOR=1.59，95CI1.40-1.78），而不是结构异常（aOR=1.03，95CI0.97-1.09）。早产的风险，低出生体重,和NICU住院的婴儿也增加了父母的高龄。结论：父亲年龄过高会增加先天性畸形的风险，尤其是后代的染色体异常,暗示产前遗传咨询是必需的。Whatisknown:•There'saincreasingtendofadvancedpaternalage,这与后代早产和低出生体重的可能性增加有关。然而,父代年龄与后代先天性异常之间的探索是有限且矛盾的。•父系年龄>44岁的婴儿出生时更有可能患有先天性异常，尤其是染色体异常.
