Paternal age at childbirth and eating disorders in offspring.
BACKGROUND
Advanced paternal age at childbirth is associated with psychiatric disorders in offspring, including schizophrenia, bipolar disorder and autism. However, few studies have investigated paternal age's relationship with eating disorders in offspring. In a large, population-based cohort, we examined the association between paternal age and offspring eating disorders, and whether that association remains after adjustment for potential confounders (e.g. parental education level) that may be related to late/early selection into fatherhood and to eating disorder incidence.


METHODS
Data for 2 276 809 individuals born in Sweden 1979-2001 were extracted from Swedish population and healthcare registers. The authors used Cox proportional hazards models to examine the effect of paternal age on the first incidence of healthcare-recorded anorexia nervosa (AN) and all eating disorders (AED) occurring 1987-2009. Models were adjusted for sex, birth order, maternal age at childbirth, and maternal and paternal covariates including country of birth, highest education level, and lifetime psychiatric and criminal history.


RESULTS
Even after adjustment for covariates including maternal age, advanced paternal age was associated with increased risk, and younger paternal age with decreased risk, of AN and AED. For example, the fully adjusted hazard ratio for the 45+ years (v. the 25-29 years) paternal age category was 1.32 [95% confidence interval (CI) 1.14-1.53] for AN and 1.26 (95% CI 1.13-1.40) for AED.


CONCLUSIONS
In this large, population-based cohort, paternal age at childbirth was positively associated with eating disorders in offspring, even after adjustment for potential confounders. Future research should further explore potential explanations for the association, including de novo mutations in the paternal germline.
Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA.
K N
KN
Javaras
Department of Psychological and Brain Sciences,Indiana University-Bloomington,Bloomington, IN,USA.
M E
ME
Rickert
Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA.
L M
LM
Thornton
Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA.
C M
CM
Peat
Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA.
J H
JH
Baker
Department of Clinical Neuroscience,Karolinska Institutet,Stockholm,Sweden.
A
A
Birgegård
Department of Clinical Neuroscience,Karolinska Institutet,Stockholm,Sweden.
C
C
Norring
Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden.
M
M
Landén
Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden.
C
C
Almqvist
Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden.
H
H
Larsson
Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden.
P
P
Lichtenstein
Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA.
C M
CM
Bulik
Department of Psychological and Brain Sciences,Indiana University-Bloomington,Bloomington, IN,USA.
B M
BM
D'Onofrio
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010331:Paternal Age; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
Anorexia nervosa; eating disorders; paternal age.