Children of Older Fathers At Increasing Risk of Autism, Schizophrenia & More

A biological clock is ticking for men, too; they just don’t know it. It turns out that those legions of male sperm are more fragile than women’s ova, much more. Research indicates that the mutations in a woman’s ova are the same—15 on average—regardless of age. But the mutations in an average man’s sperm increase from 25 at age 20 to 65 at age 40! That is, there are more mutations in sperm to begin with and they increase about 260% between age 20 and 40. More, they have identified mutations that showed up only in autistic and schizophrenic children and the sperm of their fathers, mutations and risk that increase dramatically with age. They concluded that, “97% of the relevant genetic errors were attributable to the dad alone.” And there’s more, it’s not just about autism and schizophrenia. From the article:

"Men have had this 'I'm invincible' theory when it comes to reproduction," says social psychologist Susan Newman, who has written more than a dozen books on parenting and relationships. "The only thing they needed to worry about was sperm count." But for reasons both social and scientific, men may soon be worrying about a good deal more.  

Last August, a study in Nature found that older fathers face a significantly increased risk of siring a child with autism or schizophrenia, with mutations in sperm that may contribute to these conditions doubling for every 16.5 years a man ages. That paper followed an April 2012 study, also in Nature, that found older fathers are four times as likely as mothers to pass on autism-related genetic glitches, with the risk becoming especially acute after men turn just 35--precisely the age at which the ostensibly more-fragile female reproductive system is said to enter the danger zone. Between those two reports came a May study in the American Journal of Men's Health linking a father's age to preterm birth, low birth weight and stillbirth.  

These and other papers, some showing possible links between older dads and the occurrence of cleft palates and certain cancers, are leading to the inescapable conclusion that late fatherhood isn't just the amusing indulgence of an old man with a willing young wife but also a true health peril for kids, perhaps worse than those caused by an older mom. 

"The biological clock was always there for me," says Antoinette Vitale, 47, a former CPA and now a full-time mother living in Westchester County in New York. Vitale had her three children when she was 38, 40 and 42--the age range at which doctors and well-meaning relatives start sounding alarms. Her husband, who's a year older, was spared such procreative prodding. The next generation of fathers may not have it so easy. "Men haven't paid much attention to their biological clocks," says Newman, "and now they have to." 

---“Too Old to Be A Dad?” by Jeffrey Kluger, Time (4.22.2013)

 

But this is the first time I’ve heard or read this—and I hear and read quite a lot from all kinds of news sources, including reporting on health and science. How many times have you heard or read anything about increasing genetic deterioration in men’s sperm as they age, and the increasing danger to children they might father? How many understand this? I’m guessing most other men have not heard of this research either. As Ms. Newman is quoted, above, "Men haven't paid much attention to their biological clocks," and now they have to." But first, they have to educate men. And that would require broad-based educational programs, national programs, to inform men, women, couples—all who share in the responsibility for bringing children into the world. Shouldn’t all understand the elevated levels of risks contributed by older men, risks that appear as great or greater than those contributed by older women?

 

Still, before we get too exercised about the risks involved, let me note that the absolute risks of an older father or a younger father having an autistic or schizophrenic child are not provide in the article. We are not told what a “significantly increased risk” is. Does a doubling or tripling of mutations in sperm mean a 10% increase, a 50% or 100% increase in the incidence of autism, for example? And, again, what is the baseline risk, what level of incidence is it an increase over, .1% or 1% or 10%? The CDC (Center for Disease Control) website reports that the incidence of autism was 1 in 88 births in 2008, about 1.1%, indicating a strong upward trend from the 1 in 150 births in 2000, .6 of 1%. But that doesn’t tell us what the incidence is for younger fathers or older fathers. The answers to those questions really make a difference in how much more at risk you really are, don’t they?

 

And yes, there are many more cases of autism diagnosed today than there were only a decade or so ago. Is that attributable to many more older dads in those more recent years? It’s hard not to think that, and it does seem implied by the data, but the article does not go that far. But the article does give many examples of older men, including many celebrities, having children that appear to be perfectly normal and healthy. But having shared that qualifying perspective doesn’t change the conclusion that older men have more children with these problems, even if we are not told just how many more or what percentage increase that might be.

 

The Time article moves toward conclusion reviewing those other factors that bear on the wisdom of later-in-life fatherhood, including the challenges for older fathers in rearing children. And while there are some other factors that can make older dads better parents, there are others that may limit their effectiveness, most of which have long been understood. It’s a fascinating article—an attention grabber, really—especially if you’re a man. But surely it’s just as important a concern to the wives of older men, regardless of which of them has decided they might like to be a parent (again?) after all? It’s an article worth reading and understanding by everyone.

 

 

Addendum (5.2.2013)

 

An anonymous commenter picked up on my cautionary paragraph addressing the absence of clear data or conclusions in the article about the rate of increase in the incidence of autism for older fathers. He referenced a New York Times article that he said concluded that the risk to older men was still very low. I found the article, and indeed that's just what it concludes:

Experts said that the finding was hardly reason to forgo fatherhood later in life, though it might have some influence on reproductive decisions. The overall risk to a man in his 40s or older is in the range of 2 percent, at most, and there are other contributing biological factors that are entirely unknown. 

---"Father's Age is Linked to Risk of Autism and Schizophrenia," by Benedict Carey, New York Times (8.22.2012

Still, there are some men and women who might pause for more reflection at the prospect of even a 2% probability, especially if the prospective mother was older and brought her own additional risks or vulnerabilities to the process. And then, from a broader perspective, the article adds that the significant increase in older men fathering children has materially contributed to the increase in the incidence of autism cases over the most recent decade or so, accounting for 20-30% of the increase. My cautionary stance remains sound: older prospective parents (and their doctors) should assure that they are well informed about the most recent research in this area and how that translates into risk for them, and be sure it is a level of risk they can be comfortable with.