The health and development of children born to older mothers in the United Kingdom: observational study using longitudinal cohort data

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e5116 (Published 21 August 2012)
Cite this as: BMJ 2012;345:e5116

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The article states that the covariates included child’s sex, child’s age, number of siblings, parity, birth weight, child breast fed for at least 6 weeks, child’s ethnic group, child being raised by lone parent, paternal age, child being raised in workless household, family income, mother’s educational attainment, and mother’s social class both the number of siblings and parity. Parity is measured by the mother’s parity at the birth of the relevant child, which, in almost all cases, is equivalent to birth order. In addition number of siblings was included as a covariate. We agree that higher birth order may lead to increased maternal experience and greater stimulation from older siblings, which will both potentially positively impact on the outcome measures. However we are confident that our covariates control for these possible effects as thoroughly as possible. Thus we are confident that any significant results are associated with maternal age and not the child’s birth order.

Competing interests: None declared

Edward Melhuish, Professor of Human Development

Alastair G. Sutcliffe, Jacqueline Barnes, Jay Belsky, Julian Gardiner

Birkbeck, University of London, Malet Street, London WC1E 7HX

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We read with great interest the article by Sutcliffe et al. suggesting that increasing maternal age is associated with improved health and development for children up to 5 years of age. We note that among the covariates the number of siblings was included in the regression modelling. However, we are unsure after reading the manuscript whether the birth order was adequately addressed. Birth order increases with maternal age. Higher birth order is an important variable as not only does it lead to increasing maternal experience but also with greater stimulation from older siblings, which will both potentially positively impact on the outcome measures. This should be clarified as it might be the birth order rather than maternal age, which is associated with better outcomes. If this is the case then this study will be sending a misleading message to the general public.

Competing interests: None declared

Anthony Liu, Paediatrician

Lauren Kim, Alison Poulton, Ralph Nanan

The University of Sydney, Nepean Hospital Penrith, 2751 NSW, AUSTRALIA

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