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Advanced maternal age during pregnancy and the risk for malignant morbidity in the childhood


In the past several decades, rates of delayed childbearing have increased, and as a result, maternal age has advanced. Our objective was to evaluate whether advanced maternal age is independently associated with an increased risk of childhood cancers in the offspring. A retrospective cohort study of women who delivered between the years 1991 and 2014 was conducted. Elderly parturients (≥ 35 years) were divided into two sub-categories: 35–39 and 40–50 years. The comparison group consisted of parturients aged 20–34 years. All hospitalizations of offspring up to the age of 18 years involving malignant morbidity were compared between the groups. A Kaplan-Meier survival curve was used to compare cumulative malignant morbidity incidence of the offspring. A Weibull regression model was used to control for confounders. During the study period, 201,738 deliveries met the inclusion criteria. Of them, 16.3% (n = 32,804) occurred in mothers aged 35 years or more (35–39 years old n = 26,145, 79.7%; 40–50 years old n = 6659, 20.3%). In the Weibull regression model, advanced maternal age exhibited no association with general malignant morbidity in the offspring up to 18 years of age (mothers aged 35–39: adjusted HR 1.06, 95% CI 0.76–1.48, p = 0.727; mothers aged 40–50: adjusted HR 0.73, 95% CI 0.36–1.46, p = 0.373). For leukemia, the regression model exhibited an independent association in maternal ages of 35–39 (adjusted HR 2.23, 95% CI 1.34–3.69, p = 0.002).

Conclusion: Advanced maternal age does not appear to raise the risk for future malignancy in the offspring up to the age 18 years. The specific nature of the association between maternal age and leukemia of the offspring necessitates further investigation.

What is Known:
• Advanced maternal age is associated with a marked elevation in the risk of different pregnancy complications and adverse pregnancy outcomes.
What is New:
Advanced maternal age does not appear to raise the risk for future malignancy in the offspring up to the age 18 years.
Leukemia of the offspring may be associated with advanced maternal age although the specific nature of the association necessitates further investigation.

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This study was not funded.

Author information

Majdi Imterat: Protocol/project development, analysis interpretation, data management, writing of the first manuscript draft.

Tamar Wainstock: Data analysis, analysis interpretation, manuscript editing.

Eyal Sheiner: Protocol/project development, analysis interpretation, data management, manuscript editing.

Joseph Kapelushnik: Analysis interpretation, manuscript editing.

Laura Fischer: Analysis interpretation, manuscript editing.

Asnat Walfisch: Protocol/project development, analysis interpretation, data management, manuscript editing.

Correspondence to Majdi Imterat.

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The authors declare that they have no conflict of interest.

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For this type of study, formal consent is not required. This is a database retrospective study. This article does not contain any studies with human participants or animals performed by any of the authors.

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Communicated by Peter de Winter

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Imterat, M., Wainstock, T., Sheiner, E. et al. Advanced maternal age during pregnancy and the risk for malignant morbidity in the childhood. Eur J Pediatr 177, 879–886 (2018). https://doi.org/10.1007/s00431-018-3136-8

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  • Follow-up
  • Elderly
  • Pediatric morbidity
  • Cancer
  • Leukemia
  • Malignancy
  • Offspring