Abstract
Objectives : To determine whether paternal factors i.e., age, tobacco use and genital tract infection increase the risk for spontaneous first trimester miscarriage. Methodology : This case control study was conducted in the Department of Obstetrics & Gynaecology, Unit V / IV, Dow Medical College & Lyari General Hospital, Dow University of Health Sciences, Karachi, Pakistan. Duration of study was two and half years, from Nov, 2007 to Apr, 2010. Inclusion criteria were pregnant women with age 20 - 35 years irrespective of parity. Exclusion criteria were known medical illness in either partner, induced abortion and recurrent miscarriages. Studied paternal factors were age, tobacco use and genital tract infection. Data was computed using SPSS version 16. Significance of paternal factors was determined by Logistic Regression Analysis. Results : Total cases studied were 200, while there were 400 controls. Mean maternal age was 27.6±4.9 years in cases and 26.5±4.5 years in controls. Mean paternal age was 35.5±6.2 years in cases and 32.3±5.4 years in controls. Paternal age was >35 years in 54.5% cases and 16.8% controls. Spearman Bivariate correlation revealed paternal age > 35 years (p=0.000) and genital tract infection (p=0.043) as significant factors. Only paternal age >35 years (p=0.000) remained significant in Final Model after entering into logistic regression. Paternal age beyond 35 years was found to be significantly related to first trimester spontaneous miscarriages.
Highlights
Spontaneous miscarriage is a common gynaecological condition creating an emotional crisis for the family
Trends towards increasing paternal age are being observed in the UK as well as USA, due to delay in marriages for attaining better socio-economic stability.[6]
Women with spontaneous first trimester miscarriage were taken as cases, while those admitted for delivery beyond 24 weeks of gestation were taken as controls
Summary
Spontaneous miscarriage is a common gynaecological condition creating an emotional crisis for the family. 1. Dr Riffat Jaleel, MBBS, FCPS, Assistant Professor, Ayesha Khan, MBBS, FRCOG, Professor, 1, 2: Obstetrics & Gynaecology, Unit II, Dow Medical College & Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan. Advancing paternal age has been shown to result in subfertility, adverse pregnancy outcomes (miscarriage, late foetal death, preterm delivery, low birth weight), birth defects (cleft lip and palate, congenital heart defects), achondroplasia, osteogenesis imperfect , Apert’s syndrome, schizophrenia, childhood cancer (brain cancer, retinoblastoma, acute lymphoblastic leukaemia) and adult cancer (breast, prostate and nervous system).[3] Possible mechanisms for these problems include single gene mutations, autosomal dominant diseases, structural abnormalities in sperm chromosomes (eg., reciprocal translocations) and multiple genetic / chromosomal defects. DNA damage in sperm of men aged 36 – 57 years was found to be 3 times that of men less than 35 years.[9]
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