Objective:

To investigate the association between parental age, age gap, and neonatal health outcomes, and to provide epidemiological evidence for preconception counseling and perinatal risk assessment.

Approach:

Key Findings:

• Both the father-older group (OR = 1.561) and the mother-older group (OR = 1.652) had significantly increased odds of neonatal diseases compared to the equal-age group.
• After adjustment for individual parental ages, the father-older association became non-significant (OR = 1.121), while the mother-older association remained marginally significant (OR = 1.012).
• Maternal age (OR = 1.080) and paternal age (OR = 1.051) were identified as independent risk factors.
• Significant interactions were observed between age gap and maternal age (OR = 1.098) and between maternal and paternal ages (OR = 1.098).
• The risk of adverse neonatal outcomes accelerated after maternal age >30.1 years and paternal age >40.2 years.

Interpretation:

Both maternal and paternal ages are independent risk factors with nonlinear dose-response relationships.

Conclusion:

The combined structure of parental ages should be considered in preconception counseling and perinatal risk assessment.

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