Journal of Preventive Medicine and Public Health

Original Articles

Interactive Effects of Parental Age on Adverse Birth Outcomes in Japan: An Investigation of Nationwide Birth Data: Tasuku Okui; J Prev Med Public Health. 2026;59(5):458-467. Published online July 14, 2026; DOI: https://doi.org/10.3961/jpmph.26.044

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Abstract Summary PDF Supplementary Material: Objectives
We investigated the interactive effects of parents’ ages, as well as the overall effects of paternal age, on adverse birth outcomes using nationwide data from Japan.
Methods
Live birth data from the Vital Statistics Surveys in Japan from 2010 to 2023 were analyzed. Preterm birth, low birth weight, macrosomia, small-for-gestational-age (SGA) status, and large-for-gestational-age status were defined as adverse birth outcomes. Log-binomial regression models were used to examine associations between maternal and paternal ages and adverse birth outcomes. In addition to regression analyses using maternal and paternal age groups separately, we conducted regression analyses using combined parental age groups to assess interactive effects.
Results
Data from 12 279 842 live births were analyzed. Overall, the risk ratio (RR) increased significantly with an increase in the paternal age categories for all adverse birth outcomes. In contrast, among mothers aged ≥30 years, the RRs for preterm birth, low birth weight, and SGA status were higher for infants of fathers aged ≤24 years than for those of fathers aged ≥35 years. In particular, the RRs for these outcomes, as well as macrosomia, were highest for the combination of the youngest paternal age group (≤24 years) and the oldest maternal age group (≥40 years).
Conclusions
Analysis of nationwide birth data indicated that the effects of paternal age on adverse birth outcomes varied according to maternal age, underscoring the importance of assessing pregnancy risk according to combined parental age.; Summary

Key Message
We investigated the interactive effects of parents’ ages on adverse birth outcomes using live birth data from the Vital Statistics Surveys in Japan from 2010 to 2023. Overall, the risk ratio (RR) increased significantly with an increase in the paternal age categories for all adverse birth outcomes. In contrast, among mothers aged ≥30 years, the RRs for preterm birth, low birth weight, and small-for-gestational-age status were higher for infants of fathers aged <25 years than for those of fathers aged ≥35 years.

Effects of Socio-demographic Factors on the Decreasing Trend in the Sex Ratio at Birth in Korea, 1997-2017: Jisuk Bae; J Prev Med Public Health. 2020;53(5):371-380. Published online August 7, 2020; DOI: https://doi.org/10.3961/jpmph.20.282

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Abstract PDF Supplementary Material: Objectives
This study investigated the effects of socio-demographic factors on the decreasing trend in the sex ratio at birth from 1997 to 2017 in Korea.
Methods
Data from 10 349 602 live births registered with Statistics Korea from 1997 to 2017 were analyzed. The secondary sex ratio (SSR), defined as the ratio of male to female live births, during the study period (1997-1999 [phase I], 2000-2002 [phase II], 2003-2005 [phase III], 2006-2008 [phase IV], 2009-2011 [phase V], 2012-2014 [phase VI], and 2015-2017 [phase VII]) was calculated according to selected socio-demographic factors, such as parental age, education, occupation, and birth order. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals for a male birth after adjusting for potential confounders.
Results
The SSR gradually decreased from 1.10 (in 1998-2000 and 2002) to 1.05 (in 2013-2016). While a decreasing trend in the SSR was not noted among first births, male-biased sex ratios were prominent among third and higher-order births, for which the highest SSR was 1.46 in 1998. Higher birth order was significantly associated with an excess of male births in phases I-VI (≥third vs. first, OR range, 1.03 to 1.35). Advanced maternal age was significantly associated with an excess of female births in phases II, III, and V (≥40 vs. 20-24 years, OR range, 0.92 to 0.95).
Conclusions
This study demonstrated that advanced maternal age and reduction of the artificially-biased SSR among third and higher-order births may partially explain the decreasing trend in the SSR from 1997 to 2017 in Korea.; Summary

Impact of Changes in Maternal Age and Parity Distribution on the Increasing Trends in the Low Birth Weight and Very Low Birth Weight Rates in South Korea, 2005-2015: Yujin Oh, Jisuk Bae; J Prev Med Public Health. 2019;52(2):123-130. Published online March 14, 2019; DOI: https://doi.org/10.3961/jpmph.18.247

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Abstract Summary PDF

Objectives
The aim of this study was to evaluate the impact of shifts in maternal age and parity on the increasing trends in the low birth weight (LBW) and very low birth weight (VLBW) rates from 2005 to 2015 in South Korea.
Methods
Data from 4 993 041 live births registered with Statistics Korea during the period between 2005 and 2015 were analyzed. Applying a modified standardization method, we partitioned the total increment in the LBW and VLBW rates into (1) the increase in the LBW and VLBW rates due to changes in the maternal age and parity distribution (AP-dis) and (2) the increase due to changes in the age-specific and parity-specific rates (AP-spe) of LBW and VLBW for singleton and multiple births, respectively.
Results
During the study period, the total increment in the LBW and VLBW rates was 1.43%p and 0.25%p, respectively. Among singleton births, changes in the AP-dis accounted for 79% (0.34%p) and 50% (0.06%p) of the total increment in the LBW and VLBW rates, respectively. Meanwhile, among multiple births, changes in the AP-dis did not contribute to the increase in the LBW and VLBW rates, with 100% of the increase in the LBW (1.00%p) and VLBW (0.13%p) rates being attributed to changes in the AP-spe.
Conclusions
This study demonstrated that shifts in maternal age and parity were prominent contributors to the increase in the LBW and VLBW rates among singleton births between 2005 and 2015 in South Korea.

Summary

Korean summary
우리나라 출생자료를 이용하여 2005년부터 2015년까지 한국인 저출생체중아 및 극소저출생체중아 발생률 증가에서 1) 산모연령 및 출산순위 분포변화에 기인하는 부분과 2) 이들 분포변화 이외의 요인에 기인하는 부분을 수정된 표준화법을 적용하여 평가하였다. 분석 결과, 단태아에서 저출생체중아 발생률 증가량의 79% (0.34%p), 극소저출생체중아 발생률 증가량의 50% (0.06%p)가 산모연령 및 출산순위 분포변화에 기인한 것으로 나타났다. 반면, 다태아에서는 저출생체중아 및 극소저출생체중아 발생률 증가량의 100% (저출생체중아 1.00%p, 극소저출생체중아 0.13%p)가 이들 분포변화 이외의 요인에 기인한 것으로 나타났다.

Citations

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Changes in the Distribution of Maternal Age and Parity and Increasing Trends in the Low Birth Weight Rate in Korea Between 1995 and 2005: Jisuk Bae, Jung Han Park, Yoo Keun Park, Jong-Yeon Kim, Sang-Won Lee, Soon-Woo Park; J Prev Med Public Health. 2011;44(3):111-117. Published online May 17, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.3.111

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11 Crossref

Abstract PDF

Objectives

This study measured the impact of shifts in maternal age and parity on the increase in the low birth weight (LBW) rate in Korea.

Methods

We obtained raw data for all 6 397 945 live births registered at the Korea National Statistical Office between 1995 and 2005. We calculated the proportion of increment in the LBW rate due to changes in the distribution of maternal age and parity (AP-dis) and the proportion due to changes in the age- and parity-specific LBW rate (AP-spe).

Results

The LBW rate increased from 3.02% in 1995 to 4.28% in 2005. The multiple birth rate increased from 1.32% to 2.19% during the same period. Of the 1.26% points increment in the LBW rate, 0.64% points occurred among singleton births and 0.62% points occurred among multiple births. Changes in the AP-dis accounted for 50% of the increase in the LBW rate among singleton births, but did not contribute to the increase in the LBW rate among multiple births. The remainder of the total increment in the LBW rate was explained by the increase in the AP-spe.

Conclusions

This study demonstrated that shifts in maternal age and parity among singleton births and increased multiple births were important contributors to the increment in the LBW rate. This study also revealed that the increase in the AP-spe was an equally important contributor as the shifts in maternal age and parity to the increment in the LBW rate among singleton births and was a major contributor among multiple births.

Summary

Citations

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