Advanced Maternal Age Associated with AIS?

[jrnyc]

only if studies are valid are they worthy of attention...

all kinds of studies have been done with faulty methods, or other factors that make
them invalid

studies with small numbers of participants do not mean much to me...regardless of whether i "like" what the studies claim to prove or not...

jess

[Pooka1]

Pediatric radiology: the requisites - Google Books Result

Johan G. Blickman, Bruce R. Parker, Patrick D. Barnes - 2009 - Medical - 358 pages

Adolescent idiopathic scoliosis is familial and most commonly seen in females.

http://books.google.com/books?id=Woe...ial%22&f=false

[Ballet Mom]

The "guilt trip" due to maternal age seems to be a repeating theme on this thread. I don't understand why it would make anyone feel guilty....what could they have done differently?

And if there are a bunch of studies that all show roughly the same thing, it wouldn't be up to people to just discard them because they don't like what they say.

[Ballet Mom]

My sister who has scoliosis was born when my mom was 21
I was born when my mom was 24(I am the worse case)
My brother, with the slightest case, was born when my mom was 26.

My mom, who has a scoliosis which progressed her whole life, was born when her mom was 29 and her father was 20(!) yes it's true.
Her sister, my aunt, had a perfectly straight back when she died at 91 and was born when her mom, was 31.

Go figure.

Not sure the maternal age thing is really relevant. A few studies don't really "prove' anything and who needs the guilt. There are things which are beyond our control.

Regarding Downs: a classmate of mine had a Downs baby at 22.

Recent investigations are focusing on genetic effects of parental habits--which can alter the sperm or egg- before they become parents and that these can be passed down to future generations.

You would also be classified in the familial category. It seems to me it acts differently than other types. It seems to have a much more genetic basis for inheritance. I am simply trying to pinpoint other reasons that other types of scoliosis might develop. It's certainly not saying that everyone develops scoliosis because they had a big baby and hard delivery.

I really don't understand the "guilt" part. Do you and others blame other moms for having Down's syndrome kids?

[jrnyc]

yup, i kinda agree with that...tried to say so in the early stages of this thread...

i am not impressed with the "research"...because i don't consider the numbers surveyed large enough to be convincing...but that is just my own opinion...

jess

[Karen Ocker]

Maternal age????

My sister who has scoliosis was born when my mom was 21
I was born when my mom was 24(I am the worse case)
My brother, with the slightest case, was born when my mom was 26.

My mom, who has a scoliosis which progressed her whole life, was born when her mom was 29 and her father was 20(!) yes it's true.
Her sister, my aunt, had a perfectly straight back when she died at 91 and was born when her mom, was 31.

Go figure.

Not sure the maternal age thing is really relevant. A few studies don't really "prove' anything and who needs the guilt. There are things which are beyond our control.

[Pooka1]

Here's another clearly showing that "multifactorial" is a mode of inheritance suggested for familial AIS, not something meant to include germs or sunlight...

http://www.ejbjs.org/cgi/content/full/82/8/1157

Despite documentation of the familial nature of this condition, the mode of inheritance has been debated. Studies based on a wide variety of populations have suggested an autosomal dominant, X-linked, or multifactorial inheritance pattern15,22,37,61

[Pooka1]

Here's another stating familial is multifactorial... (emphasis added)

http://www.spinebracespecialists.com...0Scoliosis.pdf

Clinical observations and results of genetic studies have
shown the familial nature of idiopathic scoliosis and
have supported the proposal that the cause of this disease
is genetic. The method of inheritance, however, is unsolved.
Multiple clinical studies support either an autosomal
dominant, multifactorial, or X-linked inheritance
pattern for familial idiopathic scoliosis. Wynne–
Davies61 demonstrated that this disease is hereditary,
suggesting either a dominant- or multiple-gene inheritance
pattern,61 whereas Cowell et al12 proposed a dominant
mode of inheritance, possibly with a sex-linked
dominant pattern.12 Fisher and DeGeorge17 concluded
that there is no simple genetic explanation for this condition
when affected pedigrees are definitively diagnosed
by spinal radiograph.17

Multifactorial in all these cases means complex genetic inheritance pattern, NOT germ theory or anything other than genetic inheritance.

[Pooka1]

Here is an abstract of a familial set of cases that are multifactorial...

http://www.ncbi.nlm.nih.gov/pubmed/20425822

This is why I didn't go into biology...

[Pooka1]

I could also be convinced that the familial type of scoliosis is different from the multifactorial AIS, although probably similar. It just seems to me that their inheritance is much different that what we have experienced in our genetic tree. It seems like most of the juvenile cases of scoliosis come from familial-type scoliosis families. That may be incorrect, but it sure seems to be the case on this forum.

I don't think "familial" and "mulitfactorial are two different categories. Familial cases are also multifactorial as far as I know. AIS is though to be polygenic and multifactorial.

Here is a definition of "multifactorial" as it is used in all these papers... what is clear is that "inheritance" is assumed whether mentioned or not. So when you see "multifactorial" it is referring to different modes of inheritance and is clearly still all genetic inheritance. As such, it is similar to "environmental" in terms of how these guys use these terms to mean genetics.

http://www.posna.org/education/Study...lDisorders.asp

I read that familial cases are 25% of the AIS cases, so they are actually a subset of the larger scoliosis population.

Can you post a reference about this? I can't find one making this distinction.

In any case, I really think they need to determine who has the true familial type of scoliosis and consider them as possibly distinct from the probably more environmentally influenced cases, when considering genetic research and testing.

Again, familial, multifactorial, and environmental are all genetic per these researchers. I agree it is a weird terminology but it's their game.

[hdugger]

I think there may be some association, in girls, if the exercise pushes out the age for onset of menstruation.

[Dingo]

I used to believe that AIS was more common in child atheletes, now I'm not so sure.

Adolescent Idiopathic Scoliosis and Exercising: Is There Truly a Liaison?

Summary of Background Data. The potential association between AIS and exercising remains uncertain. The latter has often been considered as a therapeutic means and a causative factor of the former.

Methods. A group of 2387 adolescents (boys: 1177, girls: 1210, mean age: 13.4 years) was evaluated. All completed a questionnaire concerning personal, somatometric, and secondary sex characteristics, type, duration and character of daily-performed physical activities, and existing cases of AIS among relatives. Patients were classified into 2 groups according to their answers; “athletes” and “nonathletes.” The groups were comparable as far as age, height, weight, onset of menstruation, family history of scoliosis, and side of handedness were concerned. Children underwent physical examination by 3 orthopedic surgeons who were unaware of their level of athletic activities. Children considered, by all, to be suspicious of suffering from scoliosis, underwent further radiographic evaluation.

Results. In 99 cases (athletes: 48, nonathletes: 51), AIS was radiographically confirmed (Cobb angle >10°). No statistically significant difference was found between athlete and nonathlete adolescents (P = 0.842), athlete and nonathlete boys (P = 0.757), and athlete and nonathlete girls (P = 0.705), as far as the prevalence of AIS was concerned. The mean value of the Cobb angle of the main scoliotic curve was not statistically different between male athletes and nonathletes (P = 0.45) and female athletes and nonathletes (P = 0.707). With the Cobb threshold reset at 20°, no statistically significant differences were detected either.

Conclusion. Our results demonstrate that systematic exercising is probably not associated with the development of AIS. Actively participating in sports activities doesn’t seem to affect the degree of the main scoliotic curve either.

---

I'm open to the possibility that the results might have been different if only top tier atheletes were studied.

[Ballet Mom]

I could also be convinced that the familial type of scoliosis is different from the multifactorial AIS, although probably similar. It just seems to me that their inheritance is much different that what we have experienced in our genetic tree. It seems like most of the juvenile cases of scoliosis come from familial-type scoliosis families. That may be incorrect, but it sure seems to be the case on this forum.

Juvenile cases are much more intent on climbing to surgical range no matter the treatment. Are the non-juvenile familial cases also harder to treat? Familial cases are what has been used to create the Scoliscore...should it really only be used on familial cases? It may not be predicting anything on the multifactorial cases of scoliosis.

I read that familial cases are 25% of the AIS cases, so they are actually a subset of the larger scoliosis population. And I suppose people might have been classified in that 25% such as my family even though they only have a distant family relationship.

Perhaps the familial cases are simply unlucky in having some gene like the double-jointedness gene present on both sides of the family tree and therefore get a much greater genetic influence than those that only have in on one side of the family tree. This doesn't mean that those with greater joint hyper-extension would get larger cases of scoliosis because there are girls with truly huge hyper-extension in their knees which have less scoliosis in ballet then my daughter. Maybe it just affects the progression for some reason.

In any case, I really think they need to determine who has the true familial type of scoliosis and consider them as possibly distinct from the probably more environmentally influenced cases, when considering genetic research and testing.

[Ballet Mom]

This actually brings up one thing I wanted to say about the original reason for this thread. I read through the advanced maternal age papers. And while it seems to carry a bit of consistency through several different studies, it seems more like an anomaly or weird coincidence in the data. If there is actually something to it, the wide range of time and different countries in which the studies were done would make it nearly impossible to make a suggestion as to why advanced maternal age would do anything to affect the curve. I'll also say that the differences in age in the studies is pretty small. The study that compared 'scoliosis mothers' to the general population had an age difference of less than 1 year. Something like 27.5 versus 28.3. It would be pretty difficult to say that extra .8 years was the deciding factor.

I actually think this is quite an interesting line of thought. My daughter's great-grandfather whose sister had a severe case of scoliosis was a thirteen pound baby! The odds are that his sister was also a very large baby. Did she have some kind of trauma and damage during delivery that could have caused the scoliosis during later growth increased by the fact that they have the double-jointedness gene?

My son was born at 9 lbs 8 oz. The OB/GYN thought he'd just delivered a UCLA football player. The nurses who would come into my room would exclaim they couldn't believe I was the one who had the big baby...because I wasn't big or overweight. My daughter was induced two weeks early to try and keep her size down due to her brother's weight. She turned out to be 8 1/2 pounds anyway. I did not have increased weight or gestational diabetes, am not black, and did not have any of the things that typically increase the size of newborns. We just have big babies, I guess. Funny thing, neither of my kids actually ended up big. No football players in my family!

And big babies are known to increase with age due to higher maternal weight and gestational diabeties which increase around the age of thirty. Sounds familiar with the studies, doesn't it? And now scoliosis is decreasing, and use of forceps is decreasing and c-sections are increasing.

It's just kind of interesting that scoliosis shows up at a higher rate in athletes, especially ballet, gymnastics and swimming, I believe. So maybe this possible birth trauma could cause the scoliosis with the repetitive motions in these intense activities and take-off during the adolescent growth spurt.

I hardly think it's something to just write off. There may be something to it for an enterprising researcher.

[Pooka1]

Which path is better?

Many factors but one deals with actually leaving the starting gate...

I can say that in my cohort of PhD students, of the few who never finished, most (not all) of those had kids.