Durkin Maureen S, Maenner Matthew J, Newschaffer Craig J, Lee Li-Ching, Cunniff Christopher M, Daniels Julie L, Kirby Russell S, Leavitt Lewis, Miller Lisa, Zahorodny Walter, Schieve Laura A
Waisman Center, University of Wisconsin School of Medicine and Public Health, 789 WARF, 610 Walnut Street, Madison, WI 53726, USA.
Am J Epidemiol. 2008 Dec 1;168(11):1268-76. doi: 10.1093/aje/kwn250. Epub 2008 Oct 21.
This study evaluated independent effects of maternal and paternal age on risk of autism spectrum disorder. A case-cohort design was implemented using data from 10 US study sites participating in the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring Network. The 1994 birth cohort included 253,347 study-site births with complete parental age information. Cases included 1,251 children aged 8 years with complete parental age information from the same birth cohort and identified as having an autism spectrum disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. After adjustment for the other parent's age, birth order, maternal education, and other covariates, both maternal and paternal age were independently associated with autism (adjusted odds ratio for maternal age > or =35 vs. 25-29 years = 1.3, 95% confidence interval: 1.1, 1.6; adjusted odds ratio for paternal age > or =40 years vs. 25-29 years = 1.4, 95% confidence interval: 1.1, 1.8). Firstborn offspring of 2 older parents were 3 times more likely to develop autism than were third- or later-born offspring of mothers aged 20-34 years and fathers aged <40 years (odds ratio = 3.1, 95% confidence interval: 2.0, 4.7). The increase in autism risk with both maternal and paternal age has potential implications for public health planning and investigations of autism etiology.
本研究评估了母亲年龄和父亲年龄对自闭症谱系障碍风险的独立影响。采用病例队列设计，使用来自美国10个研究地点的数据，这些研究地点参与了疾病控制和预防中心的自闭症及发育障碍监测网络。1994年出生队列包括253,347例有完整父母年龄信息的研究地点出生病例。病例包括1251名8岁儿童，他们来自同一出生队列，有完整的父母年龄信息，并根据《精神疾病诊断与统计手册》第四版修订标准被确定为患有自闭症谱系障碍。在对另一方父母的年龄、出生顺序、母亲教育程度及其他协变量进行调整后，母亲年龄和父亲年龄均与自闭症独立相关（母亲年龄≥35岁与25 - 29岁相比，调整后的优势比 = 1.3，95%置信区间：1.1, 1.6；父亲年龄≥40岁与25 - 29岁相比，调整后的优势比 = 1.4，95%置信区间：1.1, 1.8）。父母年龄较大的头胎后代患自闭症的可能性是母亲年龄在20 - 34岁且父亲年龄<40岁的三胎或更晚出生后代的3倍（优势比 = 3.1，95%置信区间：2.0, 4.7）。母亲年龄和父亲年龄增加导致自闭症风险上升，这对公共卫生规划和自闭症病因研究具有潜在意义。
