Bellieni Carlo Valerio
Carlo Valerio Bellieni, Neonatal Intensive Care Unit, University Hospital "Le Scotte", Viale M. Bracci, 53100 Siena, Italy.
World J Clin Pediatr. 2012 Dec 8;1(4):34-6. doi: 10.5409/wjcp.v1.i4.34.
Delayed childbearing (DC) is common in most Western countries. The average age of first-time mothers increased in United States from 21.4 years in 1970 to 25.0 years in 2006 and from 25.4 to 30.8 years in Australia in the same period. It is commonly believed that this has no ominous consequences. But several negative consequences of this behavior are described: stillbirth, prematurity, twins, birth anomalies. Age also decreases women's fertility, thus many couples undergo in vitro fertilization. And we highlight a paradox: medical reproduction techniques decreases their effectiveness with maternal age, but their availability can be an incentive to postpone parenthood. Of course the risks of delayed parenthood involve a minority of cases, but are parents entitled to accept any risk on the behalf of their baby A complete information would make people cautious before deciding to postpone childbearing, though this is often an obliged rather that a free choice: the consumerist society pressure and the difficulty to find an employment have their heavy weight in this choice. But if this choice is not really free, people's interest is to overcome these pressures and to claim for a real broad choice on when becoming parent, despite the pressures made by their cultural environment to postpone parenthood. Moreover, even reproductive techniques have some risks. Unfortunately, mass media often praise and endorse DC, disregarding the increase of premature babies born because of DC, a real alarm for public health. Pediatricians should discourage the culture that makes DC a normal event.
晚育在大多数西方国家很常见。美国首次生育母亲的平均年龄从1970年的21.4岁增至2006年的25.0岁，同期澳大利亚则从25.4岁增至30.8岁。人们普遍认为这不会带来不良后果。但这种行为存在一些负面后果：死产、早产、双胞胎、出生异常。年龄还会降低女性的生育能力，因此许多夫妇会接受体外受精。我们强调一个矛盾之处：医学生殖技术的效果会随着母亲年龄增长而降低，但其可获得性却可能促使人们推迟生育。当然，晚育的风险只涉及少数情况，但父母有权代表他们的孩子接受任何风险吗？完整的信息会让人们在决定推迟生育前谨慎行事，尽管这往往是一种无奈之举而非自由选择：消费主义社会的压力以及找工作的困难在这个选择中起了很大作用。但如果这个选择并非真正自由，人们的利益在于克服这些压力，并要求在何时成为父母方面有真正广泛的选择，尽管他们的文化环境存在促使推迟生育的压力。此外，即使生殖技术也存在一些风险。不幸的是，大众媒体常常赞扬和认可晚育，而忽视了因晚育导致的早产婴儿数量增加这一公共卫生方面的真正警报。儿科医生应抵制将晚育视为正常现象的文化。
