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The Father Factor [Preview]

Could becoming a father after age 40 raise the risks that your children will have a mental illness?

When my wife, Elizabeth, was pregnant, she had a routine ultrasound exam, and I was astonished by the images. The baby's ears, his tiny lips, the lenses of his eyes and even the feathery, fluttering valves in his heart were as crisp and clear as the muscles and tendons in a Leonardo da Vinci drawing. Months before he was born, we were already squabbling about whom he looked like. Mostly, though, we were relieved; everything seemed to be fine.

Elizabeth was 40, and we knew about all the things that can go wrong in the children of older mothers. We worried about Down syndrome, which is more common in the offspring of older women. Elizabeth had the tests to rule out Down syndrome and a few other genetic abnormalities. That was no guarantee the baby would be okay, but the results were reassuring to us.

The day after Henry was born, while we were still bleary-eyed from a late-night cesarean delivery, we caught part of a report on the hospital television about an increased risk of autism in the children of older fathers. Until then, all we'd thought about was Elizabeth's age—not mine. We had had no idea that my age could be an important factor in our baby's health.

When we got home, I looked up the study. Researchers had analyzed medical records in Israel, where all young men and most women must report to the draft board for mandatory medical, intelligence and psychiatric screening. They found that children born to fathers 40 or older had nearly a sixfold increase in the risk of autism as compared with kids whose fathers were younger than 30. Children of fathers older than 50—that includes me—had a ninefold risk of autism.

The researchers said that advanced paternal age, as they call it, has also been linked to an increased risk of birth defects, cleft lip and palate, water on the brain, dwarfism, miscarriage and “decreased intellectual capacity.”

What was most frightening to me, as someone with mental illness in the family, is that older fatherhood was also associated with an increased risk of schizophrenia. The risk rises for fathers with each passing year. The child of a 40-year-old father has a 2 percent chance of having schizophrenia—double the risk of a child whose father is younger than 30. A 40-year-old man's risk of having a child with schizophrenia is the same as a 40-year-old woman's risk of having a child with Down syndrome.

We would not know for two years or so whether Henry had autism. And because schizophrenia does not usually appear until the early 20s, we had decades to wait before we would know if Henry was affected.

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