Department of Public Health Sciences, University of California-Davis, Davis, CA 95616, USA.
Autism Res. 2010 Feb;3(1):30-9. doi: 10.1002/aur.116.
Reports on autism and parental age have yielded conflicting results on whether mothers, fathers, or both, contribute to increased risk. We analyzed restricted strata of parental age in a 10-year California birth cohort to determine the independent or dependent effect from each parent. Autism cases from California Department of Developmental Services records were linked to State birth files (1990-1999). Only singleton births with complete data on parental age and education were included (n=4,947,935, cases=12,159). In multivariate logistic regression models, advancing maternal age increased risk for autism monotonically regardless of the paternal age. Compared with mothers 25-29 years of age, the adjusted odds ratio (aOR) for mothers 40+ years was 1.51 (95% CI: 1.35-1.70), or compared with mothers <25 years of age, aOR=1.77 (95% CI, 1.56-2.00). In contrast, autism risk was associated with advancing paternal age primarily among mothers <30: aOR=1.59 (95% CI, 1.37-1.85) comparing fathers 40+ vs. 25-29 years of age. However, among mothers >30, the aOR was 1.13 (95% CI, 1.01-1.27) for fathers 40+ vs. 25-29 years of age, almost identical to the aOR for fathers <25 years. Based on the first examination of heterogeneity in parental age effects, it appears that women's risk for delivering a child who develops autism increases throughout their reproductive years whereas father's age confers increased risk for autism when mothers are <30, but has little effect when mothers are past age 30. We also calculated that the recent trend towards delayed childbearing contributed approximately a 4.6% increase in autism diagnoses in California over the decade.
自闭症与父母年龄的报告结果相互矛盾，无法确定是母亲、父亲还是父母双方的年龄增长导致风险增加。我们分析了加利福尼亚州一个为期 10 年的出生队列研究中父母年龄的限制层，以确定来自每个父母的独立或从属影响。加利福尼亚州发育服务部记录中的自闭症病例与州出生档案（1990-1999 年）相关联。仅包括具有完整父母年龄和教育数据的单胎出生（n=4947935，病例=12159）。在多变量逻辑回归模型中，无论父亲年龄如何，母亲年龄的增加都会使自闭症风险呈单调递增。与 25-29 岁的母亲相比，40 岁以上母亲的调整比值比（aOR）为 1.51（95%CI：1.35-1.70），或者与<25 岁的母亲相比，aOR=1.77（95%CI，1.56-2.00）。相比之下，自闭症风险与父亲年龄的增加主要与<30 岁的母亲有关：与 25-29 岁的父亲相比，40 岁以上的父亲的 aOR=1.59（95%CI，1.37-1.85）。然而，在 30 岁以上的母亲中，40 岁以上的父亲的 aOR 为 1.13（95%CI，1.01-1.27），与 25 岁以下的父亲的 aOR 几乎相同。基于对父母年龄影响异质性的首次检验，似乎女性在生育子女的过程中，其患自闭症的风险会随着生殖年龄的增长而增加，而父亲的年龄则会增加<30 岁母亲的自闭症风险，但对 30 岁以上的母亲影响不大。我们还计算出，在过去十年中，加利福尼亚州晚育趋势导致自闭症诊断增加了约 4.6%。
