Croen Lisa A, Najjar Daniel V, Fireman Bruce, Grether Judith K
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94612, USA.
Arch Pediatr Adolesc Med. 2007 Apr;161(4):334-40. doi: 10.1001/archpedi.161.4.334.
To explore the association between maternal and paternal age and risk of autism spectrum disorders (ASDs) in offspring.
Historical birth cohort study.
Kaiser Permanente (KP) in Northern California.
All singleton children born at KP from January 1, 1995, to December 31, 1999, were included in the study. We identified 593 children who had ASD diagnoses (International Classification of Diseases, Ninth Revision, Clinical Modification, code 299.0 or 299.8) recorded 2 or more times in KP outpatient databases before May 2005. These children were compared with all 132,251 remaining singleton KP births. Main Exposures Maternal and paternal age at birth of offspring.
Relative risks (RRs) estimated from proportional hazards regression models. Risk of ASDs evaluated in relation to maternal and paternal age, adjusted for each other and for the sex, birth date, and birth order of the child, maternal and paternal educational level, and maternal and paternal race/ethnicity.
Risk of ASDs increased significantly with each 10-year increase in maternal age (adjusted RR, 1.31; 95% confidence interval [CI], 1.07-1.62) and paternal age (RR, 1.28; 95% CI, 1.09-1.51). Adjusted RRs for both maternal and paternal age were elevated for children with autistic disorder (maternal age: RR, 1.18; 95% CI, 0.87-1.60; paternal age: RR, 1.34; 95% CI, 1.06-1.69) and children with Asperger disorder or pervasive developmental disorder not otherwise specified (maternal age: RR, 1.45; 95% CI, 1.09-1.93; paternal age: RR, 1.24; 95% CI, 0.99-1.55). Associations with parental age were somewhat stronger for girls than for boys, although sex differences were not statistically significant.
Advanced maternal and paternal ages are independently associated with ASD risk.
探讨父母年龄与后代患自闭症谱系障碍(ASD)风险之间的关联。
历史性队列研究。
北加利福尼亚州的凯撒医疗集团(KP)。
纳入1995年1月1日至1999年12月31日在KP出生的所有单胎儿童。我们确定了593名在2005年5月之前在KP门诊数据库中被记录2次或更多次患有ASD诊断(国际疾病分类第九版临床修订本,代码299.0或299.8)的儿童。将这些儿童与其余所有132,251名单胎KP出生儿童进行比较。主要暴露因素为后代出生时的父母年龄。
从比例风险回归模型估计相对风险(RR)。根据父母年龄评估ASD风险,并对彼此以及孩子的性别、出生日期、出生顺序、父母教育水平和父母种族/民族进行调整。
母亲年龄每增加10岁,ASD风险显著增加(调整后的RR为1.31;95%置信区间[CI]为1.07 - 1.62),父亲年龄每增加10岁,ASD风险也显著增加(RR为1.28;95%CI为1.09 - 1.51)。自闭症谱系障碍患儿和阿斯伯格综合征或未特定的广泛性发育障碍患儿的父母年龄调整后的RR均升高(母亲年龄:RR为1.18;95%CI为0.87 - 1.60;父亲年龄:RR为1.34;95%CI为1.06 - 1.69)。女孩与父母年龄的关联在某种程度上比男孩更强,尽管性别差异无统计学意义。
父母年龄较大与ASD风险独立相关。