ABSTRACT
BACKGROUND: Nonchromosomal congenital anomalies (NCAs) are the most common cause of infant mortality and morbidity. The role of maternal age is well known, although the specifics are not thoroughly elucidated in the literature. OBJECTIVE: To evaluate the role of maternal age in the incidence of NCAs and to pinpoint age groups at higher risk to refine screening protocols. STUDY DESIGN: A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines and Cochrane Handbook. Searches were performed on October 19, 2021, across MEDLINE (via PubMed), Cochrane Library (CENTRAL), and Embase. Population-based studies assessing the impact of maternal age on the incidence of NCAs in pregnant women were included, without restrictions on age range, country, or comorbidities. A random-effects model was used for pooling effect sizes, considering the heterogeneity across studies. RESULTS: From 15,547 studies, 72 were synthesized. Maternal age >35 showed an increased NCA risk (risk ratio [RR]: 1.31, confidence interval [CI]: 1.07 -1.61), rising notably after>40 (RR: 1.44, CI: 1.25 -1.66). The latter changes to 1.25 (CI: 1.08 -1.46) if the co-occurrence of chromosomal aberrations is excluded. Specific anomalies like cleft lip/palate (>40, RR: 1.57, CI: 1.11 -2.20) and circulatory system defects (>40, RR: 1.94, CI: 1.28 -2.93) were significantly associated with advanced maternal age. Conversely, gastroschisis was linked to mothers <20 (RR: 3.08, CI: 2.74 -3.47). CONCLUSION: The study confirms that both very young and advanced maternal ages significantly increase the risk of NCAs. There is a pressing need for age-specific prenatal screening protocols to better detect these anomalies, especially considering the current trend of delayed childbearing. Further research is required to fully understand the impact of maternal age on the prevalence of rarer NCAs.
ABSTRACT
The purpose of this study was to investigate the earliest stages of visual information processing using electroretinography (ERG) in patients with schizophrenia and bipolar disorder and to compare these values with those of healthy control volunteers. In the acute stage of the illness, patients with schizophrenia exhibited decreased a-wave amplitude (a measure of photoreceptor function) as compared with healthy controls. In patients with bipolar disorder, ERG measures were intact. At the baseline assessment, there was a significant negative relationship between a-wave amplitude and positive symptoms. After an 8-week follow-up period, clinical symptoms showed significant improvement and the amplitude of the a-wave significantly increased in patients with schizophrenia. At the follow-up assessment, there was no significant difference between patients with schizophrenia and controls. These results indicate that retinal dysfunctions are specific for schizophrenia, as compared with bipolar disorder, and are confined to the acute stage of the illness.
