(HealthDay News) — Advanced paternal age is associated with adverse infant and maternal outcomes, according to a study published online in The BMJ.

Yash S. Khandwala, MD, from Stanford University in California, and colleagues conducted a retrospective, population-based cohort study using data from the National Vital Statistics System. All 40,529,905 live births in the United States between 2007 and 2016 were assessed to examine the correlation between advanced paternal age and adverse infant and maternal perinatal outcomes.

The researchers found associations between older paternal age and increased risk for premature birth, low birth weight, and low Apgar score. After adjustment for maternal age, infants born to fathers aged 45 years and older versus those born to fathers aged 25 to 34 years had increased odds of admission to a neonatal intensive care unit. They had 14% higher odds of premature birth (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.13 to 1.15) and 18% higher odds of having seizures (OR, 1.18; 95% CI, 0.97 to 1.44). Advanced paternal age accounted for 13.2% of premature births (95% CI, 12.5 to 13.9%) and 14.5% of low-birth-weight infants with older fathers (95 % CI, 13.6 to 15.4%). Mothers with the oldest partners had increased risk for gestational diabetes, with 18.2% of gestational diabetes cases estimated as attributable to older paternal age (95% CI, 17.5 to 18.9%).

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“Given that many couples might not be aware of the potential impact of paternal age on perinatal health, the current findings underscore the importance of including, in reproductive life plans, discussions of paternal age and declines in sperm quality, and other risk factors such as chronic disease, that are related to age,” write the authors of an accompanying editorial.

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Khandwala YS, Baker VL, Shaw GM, et al. Association of paternal age with perinatal outcomes between 2007 and 2016 in the United States: population based cohort study. BMJ 2018;363. DOI:10.1136/bmj.k4372

Brown HK. Paternal factors in preconception care: the case of paternal age. BMJ 2018;363 DOI:10.1136/