Paternal age is associated with offspring bone health—but not soft tissue composition or fracture: the Vitamin D in Pregnancy Study

Emerging evidence suggests that paternal health may be associated with offspring later life heath. In this study, advanced paternal age at childbirth was associated with poorer offspring bone mineral density and content at age 11 years. These findings suggest that paternal age may impact childhood musculoskeletal development, warranting further investigation. INTRODUCTION: Maternal health during pregnancy is known to impact offspring's later life health. However, emerging evidence suggests that paternal factors may also be important. Advanced paternal age is associated with poorer offspring outcomes, yet few studies assess musculoskeletal outcomes. This study investigated the association between paternal age at childbirth and musculoskeletal outcomes of offspring at ages 11 and 16 years. METHODS: Data were from 402 mother-child pairs in the Vitamin D in Pregnancy study in southeastern Australia. Paternal date of birth was available for 173 fathers. Offspring lean, fat, and bone mass (spine and total body less head) were measured using dual-energy X-ray absorptiometry at age 11 years, and radiologically confirmed fractures were ascertained from birth (2002-2004) until July 19, 2019. Multivariable linear regression models were used to assess associations between paternal age and offspring bone and soft tissue composition outcomes, while multivariable Cox proportional hazards models were used to evaluate associations with offspring fracture occurrence. RESULTS: ; standard error (SE) 0.001; p = 0.046), bone mineral content (β - 5.830 g; SE 2.692; p = 0.033), and spine bone mineral content (β - 0.213 g; SE 0.0921; p = 0.023) but not spine bone mineral density or soft tissue composition. Paternal age was not associated with fracture occurrence at 16 years of age (HR 0.98; 95% CI 0.93-1.04; p = 0.51). CONCLUSION: Advanced paternal age may affect offspring musculoskeletal outcomes in childhood. This warrants further investigation in larger cohorts.