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Grand Rounds

Does Advanced Paternal Age Introduce Perinatal Risk?

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BACKGROUND AND PURPOSE:

  • There is a lack of robust data on advanced paternal age and perinatal risks associated with ART
  • Hurley et al. (AJOG, 2017) analyzed the influence of paternal age on perinatal outcomes and contrasted whether risks differed between spontaneous vs ART pregnancies.

METHODS:

  • A population-based retrospective cohort study of 1,034,552 live births
  • Exposure of interest was that of paternal age
  • Analysis was stratified by status of utilization of ART
  • Adjustments were made for maternal age, race, multifetal gestation and Medicaid status

RESULTS:

  • As paternal age increased, the use of ART in live births increased
  • Initially, frequency of perinatal complications was increased in the youngest and oldest fathers but after adjusting for maternal age, there was no paternal age effect
    • Adjusted analyses demonstrated no significant increase based on paternal age for the following adverse pregnancy outcomes
      • Preclampsia
      • Preterm birth
      • Fetal growth restriction
      • Congenital anomaly
      • Genetic disorder
      • NICU admission
    • Paternal Age had similar impact for ART and Non-ART pregnancies

CONCLUSION:

  • Advanced Paternal Age does not appear to introduce adverse perinatal outcome risk in Art and non-Art pregnancies
  • Authors acknowledge that data on birth defects conflicts with previous study by Yang et al. (Human Reproduction, 2007) which was >6 times the size of the present study
    • The current study detected a similar effect size – i.e., 0.4% increased prevalence for birth defects in the Yang et. al. paper
    • There may be an increased risk for birth defects, but absolute risk likely to be small

Learn More – Primary Sources:

Influence of Paternal Age on Perinatal Outcomes

Paternal age and birth defects: how strong is the association? Paternal age and birth defects: how strong is the association?

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Related ObG Topics:

Does ART Increase Risk of Postpartum Hemorrhage?
ASRM guidance: ART and recommended number of embryos to transfer
Infertility Treatment and Childhood Development
Does Maternal Age Affect Outcomes in Twins?

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