Are birth defects among Hispanics related to maternal nativity or number of years lived in the United States?

BACKGROUND: Literature on the risk of birth defects among foreign‐ versus U.S.–born Hispanics is limited or inconsistent. We examined the association between country of birth, immigration patterns, and birth defects among Hispanic mothers. METHODS: We used data from the National Birth Defects Prevention Study and calculated odds ratios (ORs) and 95% confidence intervals and assessed the relationship between mothers' country of birth, years lived in the United States, and birth defects among 575 foreign‐born compared to 539 U.S.–born Hispanic mothers. RESULTS: Hispanic mothers born in Mexico/Central America were more likely to deliver babies with spina bifida (OR = 1.53) than their U.S.–born counterparts. Also, mothers born in Mexico/Central America or who were recent United States immigrants (≤5 years) were less likely to deliver babies with all atrial septal defects combined, all septal defects combined, or atrial septal defect, secundum type. However, Hispanic foreign‐born mothers who lived in the United States for >5 years were more likely to deliver babies with all neural tube defects combined (OR = 1.42), spina bifida (OR = 1.89), and longitudinal limb defects (OR = 2.34). Foreign‐born mothers, regardless of their number of years lived in the United States, were more likely to deliver babies with anotia or microtia. CONCLUSIONS: Depending on the type of birth defect, foreign‐born Hispanic mothers might be at higher or lower risk of delivering babies with the defects. The differences might reflect variations in predisposition, cultural norms, behavioral characteristics, and/or ascertainment of the birth defects. Birth Defects Research (Part A), 2009. © 2009 Wiley‐Liss, Inc.     

Association of paternal age with prevalence of selected birth defects

BACKGROUND: Unlike maternal age, the effect of paternal age on birth defect prevalence has not been well examined. We used cases from the Texas birth defect registry, born during 1996-2002, to evaluate the association of paternal age with the prevalence of selected structural birth defects. METHODS: Poisson regression was used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs) associated with paternal age for each birth defect, adjusting for maternal age, race/ethnicity, and parity. RESULTS: Relative to fathers ages 25-29 years, fathers 20-24 years of age were more likely to have offspring with gastroschisis (PR 1.47, 95% CI: 1.12-1.94), and fathers 40+ years old were less likely to have offspring with trisomy 13 (PR 0.40, 95% CI: 0.16-0.96). No association was seen between paternal age and prevalence of anencephaly and encephalocele. A selection bias was observed for the other birth defects in which cases of younger fathers were more often excluded from study. CONCLUSIONS: In studies of birth defect risk and paternal age, the source of information may affect the validity of findings.     

Implications of Advancing Paternal Age: Does It Affect Offspring School Performance?

Average paternal age is increasing in many high income countries, but the implications of this demographic shift for child health and welfare are poorly understood. There is equivocal evidence that children of older fathers are at increased risk of neurodevelopmental disorders and reduced IQ. We therefore report here on the relationship between paternal age and a composite indicator of scholastic achievement during adolescence, i.e. compulsory school leaving grades, among recent birth cohorts in Stockholm County where delayed paternity is notably common. We performed a record-linkage study comprising all individuals in Stockholm County who finished 9 years of compulsory school from 2000 through 2007 (n = 155,875). Data on school leaving grades and parental characteristics were retrieved from administrative and health service registers and analyzed using multiple linear regression. Advancing paternal age at birth was not associated with a decrease in school leaving grades in adolescent offspring. After adjustment for year of graduation, maternal age and parental education, country of birth and parental mental health service use, offspring of fathers aged 50 years or older had on average 0.3 (95% CI −3.8, 4.4) points higher grades than those of fathers aged 30–34 years. In conclusion, advancing paternal age is not associated with poorer school performance in adolescence. Adverse effects of delayed paternity on offspring cognitive function, if any, may be counterbalanced by other potential advantages for children born to older fathers.     

Paternal Age and Offspring Congenital Heart Defects: A National Cohort Study

Paternal age has been associated with offspring congenital heart defects (CHDs), which might be caused by increased mutations in the germ cell line because of cumulated cell replications. Empirical evidences, however, remain inconclusive. Furthermore, it is unknown whether all subtypes of CHDs are affected by paternal age. We aimed to explore the relationship between paternal age and the risk of offspring CHDs and its five common subtypes using national register data in Denmark. A total of 1 893 899 singletons born in Denmark from 1977 to 2008 were included in this national-based cohort study. Cox’s proportion hazards model with robust sandwich estimate option was used to estimate the hazards ratio (95% confidence interval) for the associations between paternal age and all CHDs, as well as subtypes of CHDs (patent ductus arteriosus (PDA), ventricular septal defect (VSD), atrial septal defect (ASD), tetralogy of fallot (TOF) and coarctation of the aorta (CoA)). We did not observe an overall association between paternal age and offspring CHDs. However, compared to the paternal age of 25–29 years, paternal age of older than 45 years was associated with a 69% increased risk of PDA (HR45+ = 1.69, 95%CI:1.17–2.43). We observed similar results when subanalyses were restricted to children born to mothers of 27–30 years old. After taking into consideration of maternal age, our data suggested that advanced paternal age was associated with an increased prevalence of one subtype of offspring congenital heart defects (CHDs), namely patent ductus arteriosus (PDA).     

Maternal birthplace and major congenital malformations among New York Hispanics

BACKGROUND: Little is known about the association between maternal nativity and congenital malformations among Hispanics living in the United States. METHODS: We conducted a cross-sectional study to investigate the association between maternal nativity and various congenital malformations among singleton live-births born to Hispanic women in New York from 1993 to 2001. Birth certificates, used to identify maternal birthplace, were linked with congenital malformation registry files to obtain birth defects outcome. We examined how the risk of birth defects varied by maternal birthplace by estimating the adjusted odds ratios (aORs) using logistic regression. RESULTS: A foreign maternal birth showed statistically negative associations with overall congenital malformations (aOR, 0.70; 95% CI, 0.68-0.73), cardiovascular defects (aOR, 0.85; 95% CI, 0.77-0.93), central nervous system defects (aOR, 0.76; 95% CI, 0.63-0.91), and multiple defects (aOR, 0.80; 95% CI, 0.74-0.86). Specifically, foreign-born Hispanic women were statistically at reduced risk to deliver live babies with cleft palate (aOR, 0.56; 95% CI, 0.40-0.80), atresia and stenosis of rectum or anus (aOR, 0.58; 95% CI, 0.35-0.97), and craniosynostosis (aOR, 0.71; 95% CI, 0.51-0.99). Hispanic mothers born in Puerto Rico had a similar risk of delivering children with birth defects compared to U.S.-born Hispanic mothers. In contrast, Hispanic mothers born in Mexico, or Cuba and Central and South America were at reduced risk of delivering infants with overall congenital malformations (aOR, 0.64; 95% CI, 0.60-0.67) and (aOR, 0.65; 95% CI, 0.63-0.68), respectively. CONCLUSIONS: Foreign-born Hispanic mothers had a slightly lower risk to deliver live-born singleton infants with major congenital malformations than did U.S. born Hispanic mothers.     

The relationship between parental age and birth order with the percentage of low birth-weight infants

Birthweight, birth order, and parental age were abstracted from 1,515,443 New York State birth certificates to study the association between the birth of an infant weighing less than 2501 g and parental age. The percentage of premature infants was greatest for birth order 1 and 6+ and showed a minimum at birth order 3. When maternal age and birth order were analyzed jointly, a strong interaction was found. Young mothers showed a tendency to have an increasing proportion of low birthweight infants with increasing birth order, whereas, the exact opposite was true for mothers older than 45. The intermediate maternal age categories reflected this change from an association of increasing proportion of low birthweight infants with increasing birth order to a pattern of decreasing proportion of premature imfants with increasing birth order. In data stratified to eliminate the influence of maternal age and to some extent birth order, paternal age was shown to affect the percentage of infants weighing less than 2501 g. This association was described by a flat n-shaped curve that was significantly different from a horizontal line (P.01) in 6 of 7 maternal age categories.     

Influence of paternal age, smoking, and alcohol consumption on congenital anomalies

The potential effects of paternal exposures on fetal development are of great public and scientific concern, yet few epidemiologic studies have examined this association. Single live births from 1959 to 1966 among 14,685 Kaiser Foundation Health Plan members who participated in the Child Health and Development Studies were analyzed to assess the impact of paternal age, cigarette smoking, and alcohol consumption on the occurrence of birth defects in the offspring. Prevalence odds ratios for anomalies identified by age 5 were analyzed, contrasting exposed to unexposed fathers with adjustment for maternal age, race, education, smoking, and alcohol use. Advanced paternal age was associated with increased risk of preauricular cyst, nasal aplasia, cleft palate, hydrocephalus, pulmonic stenosis, urethral stenosis, and hemangioma. Father's cigarette smoking was more common among children with cleft lip +/- cleft palate, hydrocephalus, ventricular septal defect, and urethral stenosis. Alcohol use by the father was most positively related to the offspring's risk of ventricular septal defect. For both smoking and alcohol use, inverse associations were more common than positive associations. These data generally do not indicate strong or widespread associations between paternal attributes and birth defects. However, because of this study's imprecision, limited ability to isolate defects most likely to be of paternal origin, and the identification of several suggestive associations with age and smoking, further study of this issue would be of value.     

Diaplacental passage of Sarcocystis antibodies in man and rats (author's transl)]

Sera of babies up to the age of 3 months were tested for Sarcocystis antibodies using the indirect immunofluorescence test (IIFT). In addition titre of the Sarcocystis antibody level of litters born to serologic Sarcocystis positive mother rats was compared to those of their mothers. The results are as follows: 1. 45 (= 14.6%) out of 308 sera from babies up to the age of 3 months reacted positively in the Sarcocystis antibody test. 2. 28 (= 62.2%) out of the 45 positive sera were from babies up to 2 weeks old, 13 (= 28.9%) were from babies older than 2 weeks but not more than 4 weeks old, and 2 (=4.4%) each were from babies whose ages ranged from 4 to 8, and 8 to 12 weeks respectively. 3. These babies acquired their Sarcocystis antibodies which decreased in the first 3 months of life from their mothers. 4. Litters born to serologic Sarcocystis positive mother rats also demonstrated Sarcocystis antibodies. The titres of these antibodies were at the same level as their mothers' at birth but reduced gradually so that most of these young rats were negative at the age of 3 months. 5. Suckling rats born to Sarcocystis negative mothers but positive fathers remained negative. 6. Serologic positive mother and father rats still demonstrated Sarcocystis antibodies in the sera at a time when their litters have become negative. 7. Sarcocystis antibodies could be passed onto the newborn from their positive mothers in both man and rats. 8. These antibodies were probably passed onto the newborn through the placenta but their passage through the colostrum and the mother's milk cannot be ruled out.     

Extrahepatic biliary atresia with laterality sequence anomalies

The patient was the first child of first cousin parents. He was born at term after an uneventful pregnancy with normal height, weight and head circumference. Jaundice appeared at 15 days of age. Ventricular septal defects and valvular pulmonary stenosis were diagnosed. An hepatic workup revealed extrahepatic biliary atresia and abdominal situs inversus. Hepatic biopsy showed cirrhosis with intrahepatic cholestasis. Genetic factors are suggested in extrahepatic biliary atresia. Analysis of segregation patterns suggested the existence of two major groups, one with various combinations of anomalies within the laterality sequence and the other with one or two anomalies mostly involving the cardiac, gastrointestinal, and urinary systems. This patient belongs to the first group.     

Patterns of low birth weight in the Bengali newborns

This paper examines the distribution of low birth weight (2500 g or less) by gestation time, sex, maternal age, parity (birth order), socioeconomic conditions, and season of birth among 5117 single live births born to Bengali mothers at the Ramakrishna Mission Seva Pratisthan Hospital in Calcutta, India. Preterm infants have low birth weight significantly more often than their full term counterparts. Female infants have low birth weights significantly more often than male infants. The infants of poor mothers have lower birth weights in higher order births more often than infants of higher orders born to well-off mothers. Teenaged mothers produce low birth weight babies significantly more often than older mothers. Although the relationship is not significant, low birth weight infants occur more often among 1st and late born infants and less often among 2nd born infants. The season of birth is not significantly associated with birth weight. Less than 10% of low birth weight infants are pre-term, while the rest are full term. The great majority of low birth weight infants are small-for-gestational-age; the minority are small due to curtailed gestational age. The proportion of infants weighing less than 2001 g is only 9%; this figure tallies closely with earlier studies of India.     

Colonisation of babies and their families by group B streptococci.

A high incidence of group B streptococcal disease of the newborn in West Berkshire led to a prospective study of the condition. Cultures taken from 1090 babies shortly after birth showed that 65 (6%) were colonised with the streptococcus. Thirty of these babies were assigned to group 1. Bacteriological samples were taken from babies and mothers at birth and at four, eight, and 12 weeks, and also from fathers and siblings. Fifty uncolonised babies and their families were similarly studied and served as controls (group 2). In group 1,28 of the 30 mothers and 14 of the 28 fathers examined were colonised by group B streptococci. In group 2 the streptococci were isolated from three babies, 12 mothers, and 11 out of 45 fathers during follow-up. These findings suggest that group B streptococci are carried predominantly in the lower gastrointestinal and genitourinary tracts. Most families are lightly colonised, but in others maternal colonisation is stable and heavy and the incidence of paternal colonisation high. Results of serotyping suggest that sexual transmission occurs, which may explain the difficulty in eradicating the organism during pregnancy.     

Birth weight of offspring and mortality in the Renfrew and Paisley study: prospective observational study.

OBJECTIVE: To investigate the association between birth weight of offspring and mortality among fathers and mothers in the west of Scotland. DESIGN: Prospective observational study. PARTICIPANTS: 794 married couples in Renfrew district of the west of Scotland. MAIN OUTCOME MEASURES: Mortality from all causes and from cardiovascular disease over 15 year follow up. RESULTS: Women who had heavier babies were taller, had higher body mass index and better lung function, and were less likely to be smokers than mothers of lighter babies. Fathers of heavier babies were taller and less likely to be smokers than fathers of lighter babies. Mortality was inversely related to offspring''s birth weight for both mothers (relative rate for a 1 kg lower birth weight 1.82 (95% confidence interval 1.23 to 2.70)) and fathers (relative rate 1.35 (1.03 to 1.79)). For mortality from cardiovascular disease, inverse associations were seen for mothers (2.00 (1.18 to 3.33)) and fathers (1.52 (1.03 to 2.17)). Adjustment for blood pressure, plasma cholesterol, body mass index, height, social class, area based deprivation category, smoking, lung function, angina, bronchitis, and electrocardiographic evidence of ischaemia had little effect on these risk estimates, although levels of statistical significance were reduced. CONCLUSIONS: Birth weight of offspring was related inversely to mortality, from all causes and cardiovascular disease, in this cohort. The strength of this association was greater than would have been expected by the degree of concordance of birth weights across generations, but an extensive range of potential confounding factors could not account for the association. Mortality is therefore influenced by a factor related to birth weight that is transmissible across generations.     

Paternal radiation exposure and leukaemia in offspring: the Ontario case-control study.

OBJECTIVES--To test the hypothesis that there is an association between childhood leukaemia and the occupational exposure of fathers to ionising radiation before a child''s conception. DESIGN--Case-control study with eight matched controls per case. SETTING--Regions of Ontario, Canada, with an operating nuclear facility. SUBJECTS--Cases were children (age 0-14) who died from or were diagnosed as having leukaemia from 1950 to 1988 and were born to mothers living in the vicinity of an operating nuclear facility. Controls were identified from birth certificates, matched by date of birth and residence at birth. There were 112 cases and 890 controls. MAIN OUTCOME MEASURES--Paternal radiation exposure was determined by a record linkage to the Canadian National Dose Registry. RESULTS--Six fathers of cases and 53 fathers of controls had had a total whole body dose > 0.0 mSv before the child''s conception, resulting in an odds ratio of 0.87 (95% confidence interval 0.32 to 2.34). There was no evidence of an increased leukaemia risk in relation to any exposure period (lifetime or six months or three months before conception) or exposure type (total whole body dose, external whole body dose, or tritium dose), except for radon exposure to uranium miners, which had a large odds ratio that was not significantly different from the null value. CONCLUSIONS--The findings of this study in Ontario did not support the hypothesis that childhood leukaemia is associated with the occupational exposure of fathers to ionising radiation before the child''s conception.     

Reexamination of paternal age effect in Down's syndrome

Summary Paternal age distribution for 1279 cases of Down's syndrome born in 1952–1968 was compared with the corresponding distribution for the general population, corrected for the maternal age as well as for the year of birth of the patients. Although there was no difference in the mean paternal age, the two distributions differed significantly, largely due to the excess of fathers aged 55 years and over and to the deficit of those aged 40–44 years in the patients born to mothers aged 30 years and over. The overall pattern of the relative incidence of Down's syndrome with advancing paternal age, with maternal age controlled, seems consistent with the hypothesis proposed by Stene et al. (1977). It increased from 0.8 for fathers aged 20–24 years slowly up to 1.2 for those aged 45–49 years, though with an intermediate drop to 0.8 at the age of 40–44 years, and then sharply to 2.4 for those aged 55 years and over. This rising pattern of the relative incidence with paternal age was essentially the same for the patients born in 1952–1960 and for those born in 1961–1968, although the slope was less steep in the latter than in the former group.This paper is dedicated to Professor Heinrich Schade in honor of his 70th birthday     

Paternal effects on the human sex ratio at birth: evidence from interracial crosses

The effects of interracial crossing on the human sex ratio at birth were investigated using United States birth-certificate data for 1972-1979. The sex ratio was 1.059 for approximately 14 million singleton infants born to white couples, 1.033 for 2 million born to black couples, and 1.024 for 64,000 born to American Indian couples. Paternal and maternal race influences on the observed racial differences in sex ratio were analyzed using additional data on approximately 97,000 singleton infants born to white-black couples and 60,000 born to white-Indian couples. After adjustment for mother's race, white fathers had significantly more male offspring than did black fathers (ratio of sex ratios [RSR] = 1.027) and Indian fathers (RSR = 1.022). On the other hand, after adjustment for father's race, white mothers did not have more male offspring than did black mothers (RSR = 0.998) or Indian mothers (RSR = 1.009). The paternal-race effect persisted after adjustment for parental ages, education, birth order, and maternal marital status. The study shows that the observed racial differences in the sex ratio at birth are due to the effects of father's race and not the mother's. The study points to paternal determinants of the human sex ratio at fertilization and/or of the prenatal differential sex survival.     

Congenital heart disease and the specification of left-right asymmetry

Complex congenital heart disease (CHD) is often seen in conjunction with heterotaxy, the randomization of left-right visceral organ situs. However, the link between cardiovascular morphogenesis and left-right patterning is not well understood. To elucidate the role of left-right patterning in cardiovascular development, we examined situs anomalies and CHD in mice with a loss of function allele of Dnaic1, a dynein protein required for motile cilia function and left-right patterning. Dnaic1 mutants were found to have nodal cilia required for left-right patterning, but they were immotile. Half the mutants had concordant organ situs comprising situs solitus or mirror symmetric situs inversus. The remaining half had randomized organ situs or heterotaxy. Looping of the heart tube, the first anatomical lateralization, showed abnormal L-loop bias rather than the expected D-loop orientation in heterotaxy and nonheterotaxy mutants. Situs solitus/inversus mutants were viable with mild or no defects consisting of azygos continuation and/or ventricular septal defects, whereas all heterotaxy mutants had complex CHD. In heterotaxy mutants, but not situs solitus/inversus mutants, the morphological left ventricle was thin and often associated with a hypoplastic transverse aortic arch. Thus, in conclusion, Dnaic1 mutants can achieve situs solitus or inversus even with immotile nodal cilia. However, the finding of abnormal L-loop bias in heterotaxy and nonheterotaxy mutants would suggest motile cilia are required for normal heart looping. Based on these findings, we propose motile nodal cilia patterns heart looping but heart and visceral organ lateralization is driven by signaling not requiring nodal cilia motility.     

The effect of divorce on infant mortality in a remote area of Bangladesh

The process of divorce is usually lengthy and hazardous, and can start quarrels that can lead to the abuse of women and their children. This study examines the effects of divorce on neonatal and postneonatal mortality of babies born before and after divorce in Teknaf, a remote area of Bangladesh. The longitudinal demographic surveillance system (DSS) followed 1,762 Muslim marriages in 1982-83 for 5 years to record divorce, deaths of spouse, emigration and births. It recorded 2,696 live births during the follow-up period, and their survival status during infancy. Logistic regression models were used to estimate the effect of divorce on neonatal and postneonatal mortality, controlling for maternal age at birth, parity, sex of the child and household economic status. The odds of neonatal and postneonatal deaths among babies born after divorce or less than 12 months before mothers were divorced were more than double the odds of those born to mothers of intact marriages. The odds of postneonatal deaths were two times higher among babies born more than 12 months before divorce happens than their peers. The high mortality of infants born before and after mothers were divorced may reflect how abusive marriage and divorce increase the vulnerability of women and children in rural Bangladesh. Divorce and abuse of women are difficult and intractable social and health problems that must be addressed.     

Intergenerational and Genealogical Approaches for the Study of Longevity in the Saguenay-Lac-St-Jean Population

The mechanisms of longevity have been the subject of investigations for a number of years. Although the role of genetic factors is generally acknowledged, important questions persist regarding the relative impact of environmental exposures, lifestyle characteristics, and genes. The BALSAC population register offers a unique opportunity to study longevity from an intergenerational and genealogical point of view. Individuals from the Saguenay-Lac-St-Jean population who died at age 90 or older between 1950 and 1974 were selected from this database (n?=?576), along with a control group of individuals born in the same period who died between 50 and 75 years of age. For these subjects and controls, spouses’ ages at death and parental ages at death and at their birth were investigated using regression analysis. Genealogical reconstructions were carried out for each individual, and various analyses were performed on both groups. Both fathers’ and mothers’ mean ages at death were significantly higher among the longer-lived cases than among controls whereas spouses’ ages at death and parental ages at birth had no effect. Regression analysis confirmed the positive effect of both fathers’ and mothers’ age at death. Mean kinship coefficients for the parents’ generations displayed significant differences, indicating that kinship was higher among subjects than controls (this effect was stronger among the oldest 10% of the subjects). Frequencies and genetic contributions of ancestors were very similar for the two groups, and none of these ancestors appeared more likely to have introduced genetic variants involved in longevity patterns in this French Canadian population.     

Detection of IgA and IgM antibodies to HIV-1 in neonates by radioimmune western blotting.

OBJECTIVE--To detect infection with HIV-1 by IgA and IgM response at birth in children born to HIV-1 seropositive mothers. DESIGN--Western blotting and radioimmune western blotting on stored sera from infected and uninfected babies born to HIV-1 seropositive mothers. Sera were pretreated to remove IgG. SETTING--Parma and Bologna, Italy. SUBJECTS--12 infected and five uninfected babies born to HIV-1 seropositive mothers and three babies born to seronegative mothers. MAIN OUTCOME MEASURES--Effectiveness of western blotting and radioimmune western blotting in detecting antibodies to HIV-1 gene products. RESULTS--With conventional western blotting we found IgA class antibodies to HIV-1 proteins in serum from three out of 12 infected children; in two of these three the serum was collected at age 3 months (positive controls). Radioimmune western blotting detected both IgA and IgM antibodies in serum from all infected children tested, whereas all serum from uninfected children born to seropositive and seronegative mothers showed no such antibodies. CONCLUSION--Although the technique should be tested on more patients, radioimmune western blotting seems to be a valuable tool for serological diagnosis of congenital HIV-1 infection at birth in neonates born to seropositive mothers.