Teenage Fathers Are More Likely To Have Babies Affected By Birth Problems Than Fathers Over 40

Daily Science Journal (Feb. 10, 2008) — Teenage fathers are at increased risk of having babies born with birth problems ranging from pre-term delivery or low birth weight, through to death in or near to the time of delivery, according to new research.*

In contrast, the study also found that older fathers, aged 40 and over, were not at increased risk of having babies affected by these problems. The results were independent of the age of the mother or other maternal factors that might be expected to have an impact on birth outcomes.

The research is the largest study on the effects of paternal age on adverse birth outcomes. The researchers, from the Ottawa Health Research Institute, Canada, used data from the National Center for Health Statistics for nearly all the births (99%) in the USA between 1995-2000 -- a cohort of more than 23.6 million births. From these, they looked at 2,614,966 singleton babies born live to married women without previous childbearing histories, aged between 20-29, where there was complete information on paternal age, race, maternal education, prenatal care, and gestational and birth weight.

They chose women aged between 20-29 because they were the least likely to be affected by fertility problems, some of which can have an impact on birth outcomes. Since it is already known that fathers aged between 20-29 have the lowest risk of adverse birth outcomes, the researchers used this age group (the reference group) to compare all the other age groups against.

Compared to the reference group and after adjusting for confounding factors (such as race, education, smoking and alcohol drinking during pregnancy, adequacy of prenatal care and the sex of the baby), babies born to teenage fathers (aged less than 20) were more likely to be born early (a 15% increased risk), have low birth weight (13% increased risk), be small for gestational age (17% increased risk), have a low Apgar score (13% increased risk) or to die within the first four weeks after birth (22% increased risk) or to die in the period from four weeks to one year after birth (41% increased risk), although in all cases the absolute risk of death remained less than 0.5% . Fathers aged 40 or over did not have an increased risk of these adverse birth outcomes.

One of the authors of the study, Professor Shi Wu Wen, senior scientist at the Ottawa Health Research Institute and professor at the University of Ottawa, said: "Our study indicated that being a teenage father was an independent risk factor for adverse birth outcomes, whereas advanced paternal age was not. The paternal influence of younger fathers on adverse birth outcomes clearly warrants further investigation, and may lead to a deeper understanding of the causes of such outcomes.

"Although the increased relative risks for most outcomes were small, the magnitude of the risks to society could be huge, given the number of births worldwide, if the increases we found are truly attributable to paternal age."

The study looked at babies born to fathers in seven age groups, from teenagers through to those aged 50 and over, and Prof Wen said this, together with the large size of the study and the limited age range of the mothers, meant that the findings were unlikely to be affected by chance or confounding factors. However, there was no information available on the socio-economic status and lifestyle of the fathers, and this could have an impact.

"The mechanisms by which being a teenage father may contribute to an increased risk of adverse birth outcomes are not clear," said Prof Wen. "Both biological and socio-economic status might play some roles in the observed findings."

Previous studies have shown that younger men can have lower sperm counts, semen volume, total numbers of spermatozoa and percentage of motile sperm. Immature sperm may be associated with adverse birth outcomes, possibly as a result of the abnormal formation of the placenta in the uterus (placentation).

"It is biologically plausible that paternal age might play a role in the risk of adverse birth outcomes associated with abnormal placentation," said Prof Wen.

However, there are also possible social explanations too. "Young fathers are more likely to come from economically disadvantaged families and to have lower educational attainment. Socio-economic factors such as education and occupation are known to be associated with a number of health outcomes. People from less affluent backgrounds are less likely to utilise prenatal care services, which is associated with an increased risk of adverse birth outcomes," explained Prof Wen.

Other social factors that might play a role, perhaps by adversely affecting the mother's health, include domestic violence, lack of financial or emotional support, paternal illicit drug use, smoking and alcohol drinking. "These are more prevalent in teenage fathers, and previous studies have found associations between paternal smoking and alcohol and adverse reproductive outcomes," he said.

Of the finding that older fathers were not more likely to have babies affected by adverse birth outcomes, Prof Wen said: "In our present study, we did not find an association between older fathers and the increased risk of adverse birth outcomes. We could not exclude the possibility that older fathers who married women aged 20-29 years without childbearing history might have a higher socioeconomic status than our control groups. The advantaged socioeconomic conditions might offset some biological risk of adverse birth outcomes associated with older fathers."

Prof Wen said he and his colleagues were planning a pre-conception study to look at various paternal and maternal factors that might have an effect on the health of babies, including paternal age.

*Paternal age and adverse birth outcomes: teenager or 40+, who is at risk? Human Reproduction. doi:10.1093/humrep/dem403.

Adapted from materials provided by European Society for Human Reproduction and Embryology, via EurekAlert!, a service of AAAS.

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Babies Recently Treated With Lotion, Shampoo, And Powder More Likely To Have Phthalates Chemicals In Urine

Daily Science Journal (Feb. 9, 2008) — Babies recently treated with infant personal care products such as lotion, shampoo, and powder, were more likely to have manmade chemicals called phthalates in their urine than other babies, according to University of Washington and Seattle Children's Hospital Research Institute study appearing in the February issue of the journal Pediatrics. Phthalates (pronounced "thah-lates") are added to many personal care and cosmetic products, as well many common household plastic and vinyl products, and some studies suggest they may affect reproductive development in humans.

Babies recently treated with infant personal care products such as lotion, shampoo, and powder, were more likely to have manmade chemicals called phthalates in their urine than other babies. (Credit: iStockphoto/Roman Barelko)

Animal-based studies of phthalates have found that the synthetic chemicals can harm reproductive system development, and studies in humans have found that prenatal exposure or exposure through breast milk can alter hormone concentrations. Early-childhood exposure has not been extensively studied, so additional research is needed to determine if phthalate exposure can indeed cause reproductive development problems or other adverse effects in infants.

In this study, the researchers set out to see if use of personal care products was associated with urine phthalate concentrations. To accomplish this, they collected urine samples from 163 infants aged 2 months to 28 months, and measured the levels of nine different phthalates in those urine samples. They also had the babies' mothers fill out questionnaires on their use of infant personal care products in the past 24 hours.

When they cross-referenced the data, they found that the use of baby powder, lotion, and shampoo were each strongly associated with higher phthalate levels in the urine. The use of baby wipes and diaper cream were not strongly associated with increased levels of phthalates. The scientists also found that every baby had detectable levels of at least one phthalate in their urine, and about 81 percent of the infants had detectable levels of seven or more phthalates. Babies who were 8 months old or younger had stronger associations between product use and phthalate concentrations, as did babies whose mothers used more infant personal care products.

"We found that infant exposure to phthalates is widespread, and that exposure to personal care products applied onto the skin may be an important source," said the study's lead author, Sheela Sathyanarayana, an acting assistant professor of pediatrics at the UW School of Medicine and a researcher with Seattle Children's Hospital Research Institute. "This is troubling, because phthalate exposure in early childhood has been associated with altered hormone concentrations as well as increased allergies, runny nose, and eczema. Babies may be more at risk than children or adults because their reproductive, endocrine, and immune systems are still developing."

Parents who want to decrease their baby's exposure to phthalates should limit the amount of baby care products used on the infant, and apply lotions or powders only if medically indicated. Since phthalates are also found in many household plastic products, like plastic food containers, parents can also stop putting plastics in the microwave oven and use glass alternatives whenever possible. Phthalate-free cosmetics and personal care products are also available.

This research project was supported by grants from the U.S. Environmental Protection Agency, the National Institutes of Health, and the National Institute of Environmental Health Sciences. The project included researchers from the UW Departments of Occupational and Environmental Health Sciences, Pediatrics, and Biostatistics; the Seattle Children's Hospital Research Institute; the Centers for Disease Control and Prevention; and the University of Rochester School of Medicine and Dentistry.

Adapted from materials provided by University Of Washington.

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Croatian Children Have Higher Weapons-related Death Rate During And After Homeland War

Daily Science Journal (Feb. 7, 2008) — The Homeland War in Croatia, which occurred from 1991 to 1995, led to an increase in weapon-related deaths of children during and five years after the end of the war, according to a new report.

"After World War II until the beginning of the Homeland War in 1991, most children in Croatia were not exposed to firearms and explosives in their homes or communities," the authors write as background information in the article. "Unlike many countries, personal weapon ownership was not a custom in Croatia." This changed as the Homeland War--also called the Third Balkan War--moved into Croatian land. Citizens began purchasing grenades, firearms and other weapons on the black market or taking them from military barracks after the Yugoslav army left Croatia. The population remained overly militarized in the wake of the war; in 2007, 371,684 weapons were legally owned by Croatians.

Aida Mujkic, M.D., of the University of Iowa, Iowa City, and colleagues studied Croatian children from birth through age 19 who died of weapon-related injuries between 1986 and 2005. Statistics were obtained from Croatia's national vital statistics system and included traumatic injury deaths classified by intent, including homicide, suicide and unintentional categories.

Compared with the period before the war, rates of homicide and suicide with weapons more than tripled during the war--from .22 to .73 homicides and .51 to 1.64 suicides per 100,000 children. Unintentional weapon-related deaths also increased by more than six-fold, from .25 to 1.63 per 100,000 children.

"These increases persisted for five years following the end of the war and decreased more than five years after the war," the authors write. Weapons-related deaths in the early postwar period--1996 to 2000--remained more than twice as high as before the war, and the weapon-related suicide rate remained more than three times that of the pre-war period. Homicide and unintentional injury deaths decreased significantly in the late post-war period, 2001 to 2005, and suicide rates were the same as in the pre-war period. The number of children who died from causes other than weapons did not change over the course of the study.

"Programs that focus on the prevention of weapon-related injuries should be integrated into programs that assist countries in rebuilding after political unrest," the authors conclude. "The combination of psychological effects of war on children with an increased presence of weapons may present a particularly important area for prevention."

Journal reference: Arch Pediatr Adolesc Med. 2008;162[2]:140-144.

This study was supported by an NIH grant from the University of Iowa/Fogarty International Traumatic Injury Training Program.

Adapted from materials provided by JAMA and Archives Journals.

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