Grand Rounds

Is Advanced Paternal Age Associated with Increased Chance of Spontaneous Abortion?

BACKGROUND AND PURPOSE:

Nguyen et al. (AJOG, 2019) assessed the impact of paternal age on the risk of spontaneous abortion

Retrospective case-control study
Data sources
- Pregnancy data from CDC’s 2011–2013 and 2013–2015 National Survey of Family Growth
- Women 15 to 45 years | Spontaneous, singleton pregnancy
- Exclusion: Ongoing pregnancies | Induced abortions | Ectopic pregnancies | Preterm births | IUFDs
Study design and data analysis
- Pregnancy outcomes were analyzed in 3 groups
  - Spontaneous abortion (SAB) at <20 weeks
  - SAB at ≤12 weeks
  - Live birth at ≥37 weeks
- Associations between paternal age and outcomes were determined
  - Reference paternal age group: 25 to 29 years
- Odds ratio (OR) adjusted for maternal age and selected demographic and pregnancy characteristics, including
  - Race/ethnicity | Socioeconomic status | Marital status | Pregnancy intention

6,979 women | 12,710 pregnancies
- 18.2% spontaneous abortions | 81.8% term live births
- Median maternal age: 25 years
- Median paternal age: 28 years
Paternal age ≥50 years was significantly associated with SAB vs 25 to 29 years
- Adjusted OR for SAB<20 weeks: 2.05 (95% CI, 1.06 to 2.20)
- Adjusted OR for SAB ≤12 weeks: 2.30 (95% CI, 1.17 to 4.52)

Pregnancies resulting in SAB had approximately twice the odds of being from a father who was ≥50 years compared to 25 to 29 years of age
The authors suggest that since the finding was especially pronounced in the first trimester group, the effect may be mediated via genetic mutations

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