In the last few weeks, we've talked variously about this study and that which have put older parenthood in some new light. Some of the studies are somewhat frightening, particularly those about the genetic risks that come with later pregnancies. Others have been more positive, including the study from Brian Powell et al noted earlier this month that found parents 35 and older were more likely to pass on cultural, economic and social resources to their children. So, what to do with all this information?
Here's what I think: Prospective older parents need to make an informed choice, balancing the potential social benefits that they pass along to their children by waiting against the genetic realities of getting older. After a certain age, a few years plus or minus around 40, biology begins to catch up with us. Studies have shown that it's harder for older couples to conceive, and the chance for miscarriage is also higher. The risk of certain genetic conditions is also higher for older parents, as oft-noted here. That said, though there is an increase, the chances that a child will be genetically "normal" are still higher than a genetically "abnormal," for lack of better terms. It's sad but true that there are inherent genetic risks in any pregnancy. But it's also true, I've heard time and again, that many feel they are more confident parents when they get older and better able to provide a stable home for their children and are more able to give them the kind of childhood they think they should have.
Of course, the decision to have a child is not always about that child, but what the parents want for themselves and their families. I've also noted testimony here from older first-time dads how having children has completely changed their lives for the better. That's true for me too. I've gotten more from my two kids these last six years than I think I've had from anything else in my life - more laughter, more tears, more understanding, and overall just a more meaningful and fulfilling life.
I'd like to hear what you think.
Thursday, March 29, 2007
On biological clocks, risks, and rewards of older parenthood
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7 comments:
There is an association of a paternal age 35 and over with the beginning of a statistically significant risk of sporadic schizophrenia,and many other de novo genetic disorders. De novo Alzheimer's, prostate cancer, ALL, diabetes1, maybe some pre-menopausal breast cancers,autism, MS,some early childhood cancers, as well as over 30 autosomal dominant genetic disorders. Also there is an increased risk of the daughters of fathers 35 and over carrying the de novo mutations that result in Duchennes Muscular Dystrophy, hemophilias, fragile X, etc. etc. and maybe even autism to their sons. The increase in all these disorders for offspring increases with increasing paternal age at a rate that is greater than linear.
The risks involved are for the health, and emotional and intellectual life of the children, and grandchildren etc. and it is ultimately selfish for the parents to knowingly talk about risks as if it were risks for themselves.
... and even knowing all that, many would still choose to have children, just as many with autosomal dominant conditions, where there is a far greater (50%) risk choose to do so. There was a recent NYT article about people who used genetic screening to ensure that their children would have their genetic conditions, so they would be more "like them." (an approach I wouldn't endorse) My wife is in genetics and we talked about the risks all the time, some of which wouldn't show up on prenatal screens and most of which were unrelated to advanced parental age. Sometimes it scared the hell out of us. And yet, we went on...
I don't think it's selfish for parents to talk about the risks, given that many of the conditions that we're talking about here will essentially mean they will have to provide round-the-clock care for that child.
Why do you need to encourage others to act irresponsibly. Maybe they will act that way, but do you think it is moral to encourage them?
I don't know if "encouraging" is what I do - after all, the very second post I ever made was about the autism study. That said, I don't try to dissuade people either. I'm not trying to influence what people do, I'm just trying to report what they do, and the trend has been, and will likely continue to be, that people are waiting to have children. I think people make their decisions to have children based on a lot of factors. Most go into that decision presuming they will have normal children, and most of them are correct - even those of advanced age. I have mentioned often about the increased attention to biological risks, but my point is even knowing that it will only be one of the decision-making factors that prospective parents will consider. i.e., it was one, but far from the only one of the factors my wife and I considered.
But you don't know how normal the children of older fathers are. Who is studying them to find the increased risk of breast cancers, prostate cancer, ALL, diabetes 1, Alzheimer's, MS, fibromyalgia, schizophrenia, etc.; conditions that show up later in life? I think you have been applauding men who father at older ages.
I suppose it's true that I do celebrate the birth of any child to loving parents, and if those parents are older I'm doubly happy for them because the addition of a child (by birth or adoption) often comes after years of heartbreaking difficulty. If applauding that is encouraging older parents, then I guess I'd have to plead guilty.
My well-intentioned parents thought I was a "miracle" baby they never thought they'd have; they were 43 and 45, respectively, when I was born. Now I have discovered that DS (born when I was 28) and I are on the "spectrum". So, I unknowlingly passed on my disorder to my kids. I'm sure there are older parents who have "normal" kids, but you're taking a huge risk by having a late in life baby. If you truly feel you have the financial means and energy needed to have a kid in your 40s or 50s, you should consider adoption instead.
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