Advanced maternal age during pregnancy and the risk for malignant morbidity in the childhood
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).
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.
KeywordsFollow-up Elderly Pediatric morbidity Cancer Leukemia Malignancy Offspring
Majdi Imterat: Protocol/project development, analysis interpretation, data management, writing of the first manuscript draft.
Tamar Wainstock: Data analysis, analysis interpretation, manuscript editing.
Eyal Sheiner: Protocol/project development, analysis interpretation, data management, manuscript editing.
Joseph Kapelushnik: Analysis interpretation, manuscript editing.
Laura Fischer: Analysis interpretation, manuscript editing.
Asnat Walfisch: Protocol/project development, analysis interpretation, data management, manuscript editing.
Compliance with ethical statement
Conflict of interest
The authors declare that they have no conflict of interest.
For this type of study, formal consent is not required. This is a database retrospective study. This article does not contain any studies with human participants or animals performed by any of the authors.
- 2.Centers for Disease Control and Prevention. (2007) Assisted reproductive technology success rates: National Summary and Fertility Clinic Reports. Centers for Disease Control and Prevention. American Society for Reproductive Medicine, Society for Assisted Reproductive TechnologyGoogle Scholar
- 3.Central Bureau of Statistics, Number of households in 2016, Israel 2016. Available from: http://cbs.gov.il/www/publications15/meshek_bait/households.pdf
- 13.Little J. 149 ed. Lyon; Oxford: International Agency for Research on Cancer; Distributed by Oxford University Press; 1999. Epidemiology of childhood cancerGoogle Scholar
- 16.Office for National Statistics Social trends 29, 1999 Edition. The Stationery Office, LondonGoogle Scholar
- 18.Ries L. G., Smith M. A., Gurney J. G., Linet M., Tamra T., Young J. L., & Bunin G. (1999) Cancer incidence and survival among children and adolescents: United States SEER Program 1975–1995Google Scholar
- 24.Steliarova-Foucher E, Stiller C, Kaatsch P, Berrino F, Coebergh JW, Lacour B, Perkin M (2004) Geographical patterns and time trends of cancer incidence and survival among children and adolescents in Europe since the 1970s (the ACCIS project): an epidemiological study. Lancet 364(9451):2097–2105CrossRefPubMedGoogle Scholar
- 26.Statistics TCBo. (2013) Israel in figures. http://www.cbs.gov.il/www/publications/isr_in_n15e.pdf. Accessed 25 May 2015