Association between paternal age and offspring's under-5 mortality: Data from 159 surveys in 67 low- to middle-income countries

Aim To investigat the association between paternal age at birth and offspring's under-5 mortality in low- and middle-income countries (LIMCs). Methods Data from 159 population-based surveys in 67 LIMCs between 2000 and 2018 were obtained from the Demographic and Health Surveys. Cox proportional hazard regression models in consideration of complex survey design were performed to examine the associations. Results In the pooled analysis, compared with children born to fathers aged 25-29 years, those born to younger fathers aged 20-24, 16-19 and 12-15 years, respectively, were at increased risk of under-5 mortality (hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.06-1.13; HR = 1.48, 95% CI = 1.42-1.55; HR = 1.70, 95% CI = 1.56-1.84, respectively). In addition, children born to older fathers aged 40-44 and >= 45 years, also had increased risk of under-5 mortality (HR = 1.08, 95% CI = 1.03-1.15; HR = 1.12, 95% CI = 1.07-1.18, respectively). Conclusions Our findings show that children born to both younger and older fathers are at higher risk of offspring's under-5 mortality in LIMCs.