Intended for healthcare professionals


Paternal factors in preconception care: the case of paternal age

BMJ 2018; 363 doi: (Published 31 October 2018) Cite this as: BMJ 2018;363:k4466

Linked research

Association of paternal age with perinatal outcomes

  1. Hilary K Brown, assistant professor
  1. Interdisciplinary Centre for Health & Society, University of Toronto Scarborough, Toronto, ON, M1C 1A5, Canada
  1. hk.brown{at}

Standard approach to preconception care should include both sexes

The average age at first birth among women and men in developed countries has increased over the past four decades and is attributable to an increase in first births to women aged 35 or older and men aged 40 or older.12 Research has focused on the effects of advanced maternal age on adverse perinatal outcomes, including fetal loss, congenital anomalies, and preterm birth,345 but evidence is increasing of the potential contribution of advanced paternal age to these outcomes, with epigenetic changes to spermatocytes being the proposed mechanism.6

In a linked paper, Khandwala and colleagues (doi:10.1136/bmj.k4372) examined the association between paternal age and perinatal outcomes in the United States using vital statistics records for 40 529 905 live births between 2007 and 2016.7 They found that older paternal age was associated with greater odds of gestational diabetes, preterm birth, low birth weight, neonatal morbidity, and low Apgar scores. Results for pre-eclampsia …

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