Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eur J Pediatr. 2018 Jun;177(6):879-886. doi: 10.1007/s00431-018-3136-8. Epub 2018 Apr 8.
In the past several decades, rates of delayed childbearing have increased, and as a result, maternal age has advanced. Our objective was to evaluate whether advanced maternal age is independently associated with an increased risk of childhood cancers in the offspring. A retrospective cohort study of women who delivered between the years 1991 and 2014 was conducted. Elderly parturients (≥ 35 years) were divided into two sub-categories: 35-39 and 40-50 years. The comparison group consisted of parturients aged 20-34 years. All hospitalizations of offspring up to the age of 18 years involving malignant morbidity were compared between the groups. A Kaplan-Meier survival curve was used to compare cumulative malignant morbidity incidence of the offspring. A Weibull regression model was used to control for confounders. During the study period, 201,738 deliveries met the inclusion criteria. Of them, 16.3% (n = 32,804) occurred in mothers aged 35 years or more (35-39 years old n = 26,145, 79.7%; 40-50 years old n = 6659, 20.3%). In the Weibull regression model, advanced maternal age exhibited no association with general malignant morbidity in the offspring up to 18 years of age (mothers aged 35-39: adjusted HR 1.06, 95% CI 0.76-1.48, p = 0.727; mothers aged 40-50: adjusted HR 0.73, 95% CI 0.36-1.46, p = 0.373). For leukemia, the regression model exhibited an independent association in maternal ages of 35-39 (adjusted HR 2.23, 95% CI 1.34-3.69, p = 0.002).
Advanced maternal age does not appear to raise the risk for future malignancy in the offspring up to the age 18 years. The specific nature of the association between maternal age and leukemia of the offspring necessitates further investigation. What is Known: • Advanced maternal age is associated with a marked elevation in the risk of different pregnancy complications and adverse pregnancy outcomes. What is New: • Advanced maternal age does not appear to raise the risk for future malignancy in the offspring up to the age 18 years. • Leukemia of the offspring may be associated with advanced maternal age although the specific nature of the association necessitates further investigation.
评估高龄产妇是否与后代儿童癌症风险增加独立相关。
对 1991 年至 2014 年期间分娩的女性进行回顾性队列研究。高龄产妇（≥35 岁）分为两个亚组：35-39 岁和 40-50 岁。对照组由 20-34 岁的产妇组成。比较各组 18 岁以下后代的所有恶性发病率住院情况。使用 Kaplan-Meier 生存曲线比较后代累积恶性发病率。使用威布尔回归模型控制混杂因素。
研究期间，201738 例分娩符合纳入标准。其中，16.3%（n=32804）的产妇年龄在 35 岁及以上（35-39 岁 n=26145，79.7%；40-50 岁 n=6659，20.3%）。在威布尔回归模型中，高龄产妇与后代 18 岁以下的一般恶性发病率无关（母亲年龄 35-39 岁：调整 HR 1.06，95%CI 0.76-1.48，p=0.727；母亲年龄 40-50 岁：调整 HR 0.73，95%CI 0.36-1.46，p=0.373）。对于白血病，回归模型显示母亲年龄在 35-39 岁时存在独立关联（调整 HR 2.23，95%CI 1.34-3.69，p=0.002）。
高龄产妇似乎不会增加后代 18 岁以下的未来恶性肿瘤风险。高龄产妇与后代白血病之间的关联性质需要进一步研究。
高龄产妇与不同妊娠并发症和不良妊娠结局的风险显著增加有关。
高龄产妇似乎不会增加后代 18 岁以下的未来恶性肿瘤风险。
后代白血病可能与高龄产妇有关，但关联的具体性质需要进一步研究。
