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Predictors of trisomy 21 in the offspring of older and younger women

Authors

  • A. J. Agopian,

    1. Center for Human Genetics, Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, Texas
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  • Lisa K. Marengo,

    1. Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
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  • Laura E. Mitchell

    Corresponding author
    1. Center for Human Genetics, Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, Texas
    • University of Texas School of Public Health, 1200 Herman Pressler Drive, Houston, TX 77030
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  • Supported in part by a cooperative agreement (#5U01DD000494-03) between the Centers for Disease Control and Prevention (CDC) and the Texas Department of State Health Services (DSHS), as well as by Title V block grant funds at the Texas DSHS.

  • The contents of this study are solely the responsibility of the authors and do not necessarily represent the official view of the CDC.

Abstract

BACKGROUND: Advanced maternal age is the only well-established risk factor for trisomy 21, yet the majority of affected individuals are born to younger women. To identify factors associated with the risk of trisomy 21 in the offspring of younger and older women, we analyzed data for cases with trisomy 21 from the Texas Birth Defects Registry for 1999 to 2007. METHODS: Data were analyzed separately for younger (i.e., <35 years of age at delivery; n = 2306) and older (i.e., ≥35 years of age at delivery; n = 1811) women using Poisson regression. RESULTS: After adjustment for maternal age and several other covariates, the prevalence of trisomy 21 in the offspring of women in both maternal age groups was higher in male than in female infants and in offspring of women who were Hispanic (compared with non-Hispanic white women) or who had at least one previous liveborn child compared to those with none. In the offspring of older women only, the prevalence of trisomy 21 was also significantly higher when the father was 20to 24 years old (compared with 25 to 29 years old; adjusted prevalence ratio [aPR], 2.27; 95% confidence interval [CI], 1.47–3.49) and Hispanic (compared with non-Hispanic white; aPR, 1.34; 95% CI, 1.13–1.58) and among women with less than a high school education (compared with greater than high school). CONCLUSIONS: This study identified several factors, in addition to maternal age, that were associated with trisomy 21 risk. In general, these factors were similar for both maternal age groups, although paternal characteristics were significantly associated with risk of trisomy 21 only in offspring of older women. Birth Defects Research (Part A), 2012. © 2011 Wiley Periodicals, Inc.

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