Does being a father after age 40 increase the risk of a child having health problems? – 10/08/2021

Some international studies suggest that late parenthood poses health risks to unborn children. In 2014, a Swedish survey showed that parents over the age of 45 are more at risk of having children with autism, schizophrenia and other psychiatric problems. Scientists claim that spontaneous mutations accumulated in sperm DNA due to aging would be largely responsible.

Already in 2016 and more recently in 2018, other works, from Stanford University, in the United States, and published in the scientific journal BMJ, stressed that advanced paternal age affects the entire spectrum of male fertility and more, can lead to higher rates of congenital diseases (heart, dwarfism), psychiatric disorders (schizophrenia, bipolar disorder) and even cancer in children. Not even the mothers escaped the negative effects observed.

According to Michael L. Eisenberg, one of the authors of the studies and chief of male reproductive medicine at Stanford, the risk of gestational diabetes was 34% higher in mothers with older partners. For Hilary K. Brown, a reproductive public health researcher at the University of Toronto, Canada, for many years it was believed that old age only mattered to women. “But the paternal age also counts”, he guarantees.

In Brazil, the word of the experts…

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Image: iStock

Lara Sepúlveda de Andrade, physician at UFPI (Federal University of Piauí), geriatrician and preceptor of the geriatrics and gerontology clinic of the medical course at Afya Educacional, as well as Alex Meller, professor at Unifesp (Federal University of São Paulo) and urologist at the Hospital Israelita Albert Einstein (SP), agree with the studies cited that late paternity influences the occurrence of genetic alterations and deficiencies.

“The risks rise from the age of 40 and intensify from the age of 60”, points out Meller. Andrade adds: “Paternal age influences not only the characteristics of the sperm (smaller volume, change in the number and quality of sperm), but also the integrity of the DNA, and this can manifest itself in infertility, miscarriages, pregnancy problems and impairment of the health of live births.”

Geraldo Caldeira, gynecologist and obstetrician at Febrasgo (Brazilian Federation of Gynecology and Obstetrics Associations), SBHR (Brazilian Society for Human Reproduction) and the human reproduction service at Hospital Santa Joana (SP), is also in agreement and explains that for Due to aging, there are flaws in the replication of the DNA that sperm carry and that are not corrected by the body, increasing the risk of genetic deficiencies — and consequently, diseases.

However, these changes cannot be extended equally to all men, argues Andrade, claiming that the occurrence also depends on variable individual factors and is subject to damage and exposure that can occur throughout life, related to the environment, chronic diseases, alterations hormones, infections and testicular varices (varicocele).

What about late motherhood?

According to Paulo Camiz, geriatrician and professor of general practice at HC-FMUSP (University of São Paulo Medical School Hospital das Clínicas), Nelson Douglas Ejzenbaum, pediatrician and neonatologist member of the American Academy of Pediatrics and Alexandre Pupo, gynecologist and obstetrician of the Hospital Sírio-Libanês and Hospital Albert Einstein (SP), the risk of complications is much more based on the age of the mother and higher than on the fact that the father is older.

“Most studies carried out in men work at the age of 40 years and the main problems in children, with more evidence, are psychiatric, but it is something very discreet. On the part of women, the studies make it clear that, mainly from the age of 35 onwards, there is an increase in the risk, which is greater with each passing year, of having children with a trisomy, a chromosomal disorder, and one of the most common is Down syndrome”, points out Camiz.

Unlike men, who do not stop producing sperm, even after low testosterone, women have their eggs counted from birth and with increasing age it is not part of them that changes, but all of them, increasing the risks for the child, says Ejzenbaum.

“Furthermore, when the patient is over 35 years old, pregnancy is considered a risk because the body enters a stage of maturation and does not support it with the same security, it is difficult to adapt and becomes overloaded”, says Pupo.

Thus, changes in diabetes, high blood pressure (pre-eclampsia) and the risk of the child being born underweight and premature are common. As a result, more hospitalizations during pregnancy and higher maternal and fetal mortality.

Plan and seek a doctor

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Image: iStock

If the idea is to focus first on studies and careers and then start a family, that’s fine. Today, thanks to advances in reproductive medicine, with treatments (artificial insemination, in vitro fertilization, hormone replacement therapy), procedures (surgery to improve sperm production, removal, freezing and donation of biological material), supportive belly, women and men are able to have children later.

“The great importance of the studies is to draw attention to the importance of family planning for men and the monitoring of pregnancies whose parents were older,” explains Lara.

It is not to alarm, but to facilitate access to knowledge. The researcher gives other professionals the opportunity to also benefit from these data, as well as patients.

“In the case of a woman, for example, she cannot get pregnant after the age of 45, with her eggs. She would need to receive an egg donation from another woman to be able to get pregnant after that age. The uterus takes longer to age than the ovaries” , informs Boiler.

As far as men are concerned, Meller adds that, in addition to the failures in DNA replication, sperm reduce their ability to fertilize. “The process becomes more complicated, which often requires a specialized physician to improve it and even assisted reproduction.”

Therefore, if the couple is having difficulty getting pregnant, they should investigate the cause with a doctor. In conclusion, it is the right thing to do when it comes to health and fertility.