164: Risk of intrauterine fetal demise and postfetal death in women of advanced maternal age stratified by gestational age at delivery

Background: An Intrauterine Fetal Demise (IUFD) is a major obstetrical catastrophe at any gestational age but the emotional pain and distress caused by this event increases in direct relation to the duration of pregnancy. The objective of the present study was to determine the incidence and possible causes of Intrauterine Fetal Demise (IUFD), and to determine preventive measures.Methods: Retrospective observational study was done from Jan 2015 to Dec 2017 at Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune. Inclusion criteria were all the pregnant women with IUFD delivered at the centre, at or above 24 weeks of gestation. The methodology followed were parameters of assessment for analysis were maternal age, parity, probable causes for IUFD, booked or unbooked cases, mode of delivery, maternal complications, and placental histopathology. Statistical data were analyzed using SPSS version 25.Results: The incidence of IUFD at authors’ hospital was 27/1000 live births. The IUFD rate was similar in maternal age <20years and >30years (p value 0.26). The incidence of IUFD increased with decreasing gestational age which was statistically significant (p value 0.001). IUFD incidence was higher in multiparous women compared to primiparous women (p value 0.036 with OR of 1.6 and 95% CI 1.02 to 2.54). The rate of IUFD was similar when sex of the baby was analyzed. 49.4% of fetuses had signs of maceration. The major cause of IUFD was severe preeclampsia (48.1%) which included HELLP syndrome, IUGR, Abruption. Maternal anemia (20.4%), GDM (3.8%), SLE (2.5%), APLA positive (2.5%), anhydramnios (6.3%) were some of the other important causes of IUFD.Conclusions: This study was conducted to determine the incidence of IUFD and associated maternal risk factors. By understanding the contributing factors, we can seek ways of avoiding recurrence of IUFD by proper antenatal care and early diagnosis of obstetric complications and its appropriate management.

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Evaluation of Pregnancy Outcomes at Advanced Maternal Age

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.587 ◽

2019 ◽

Vol 7 (12) ◽

pp. 1951-1956 ◽

Cited By ~ 1

Author(s):

Małgorzata Radoń-Pokracka ◽

Beata Adrianowicz ◽

Magdalena Płonka ◽

Paulina Danił ◽

Magdalena Nowak ◽

...

Keyword(s):

Caesarean Section ◽

Gestational Age ◽

Maternal Age ◽

Statistical Significance ◽

Advanced Maternal Age ◽

Neonatal Outcomes ◽

University Hospital ◽

Large For Gestational Age ◽

Predisposing Factor ◽

Over 40 Years

AIM: The study aimed to investigate the association between advanced maternal age (AMA) and the risk of adverse maternal, perinatal and neonatal outcomes about parity in singleton pregnancies.METHODS: We retrospectively analysed 950 women who gave birth in the Department of Obstetrics and Perinatology of the University Hospital in Kraków for six months (between 1st January and 30th June 2018). The patients were divided into 3 groups according to their age (30-34 years old, 35-39 years old and over 40 years old). Each of these groups was subsequently subdivided into 2 groups depending on parity (primiparae and multiparae). Maternal, perinatal and neonatal outcomes were compared between the groups and the subgroups.RESULTS: Comparison of the three age groups revealed that advanced maternal age might constitute a predisposing factor for preterm birth, caesarean section and large for gestational age (LGA). From these parameters, statistical significance was reached in case of greater risk of LGA (OR = 2.17), caesarean section (OR = 2.03) and elective C-section (OR = 1.84) in women over 40 years old when compared to the patients aged 30-34. Furthermore, AMA increases the risk of postpartum haemorrhage (OR = 6.43). Additionally, there is a negative correlation between maternal age and gestational age at delivery (R = -0.106, p < 0.05).CONCLUSIONS: Advanced maternal age can undoubtedly be associated with several adverse perinatal outcomes. At the same time, the risk of perinatal complications begins to increase after the age of 35 but becomes significant in women aged ≥ 40.

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Impact of advanced maternal age on neonatal survival of twin small-for-gestational-age subtypes

Journal of Obstetrics and Gynaecology Research ◽

10.1111/j.1447-0756.2007.00521.x ◽

2007 ◽

Vol 33 (3) ◽

pp. 259-265 ◽

Cited By ~ 7

Author(s):

Sibylle Kristensen ◽

Hamisu M. Salihu ◽

Louis G. Keith ◽

Russell S. Kirby ◽

Mary A. B. Pass ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Maternal Age ◽

Advanced Maternal Age

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Smoking, maternal age, fetal growth, and gestational age at delivery

American Journal of Obstetrics and Gynecology ◽

10.1016/0002-9378(90)90819-s ◽

1990 ◽

Vol 162 (1) ◽

pp. 53-58 ◽

Cited By ~ 104

Author(s):

Shi Wu Wen ◽

Robert L. Goldenberg ◽

Gary R. Cutter ◽

Howard J. Hoffman ◽

Suzanne P. Cliver ◽

...

Keyword(s):

Fetal Growth ◽

Gestational Age ◽

Maternal Age ◽

Gestational Age At Delivery

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Difference in The Incidence Severe Preeclampsia and Eclampsia between Maternal Age 20-34 Years and >34 Years in dr. Soebandi Hospital Jember

Journal of Agromedicine and Medical Sciences ◽

10.19184/ams.v3i2.5065 ◽

2017 ◽

Vol 3 (2) ◽

pp. 18

Author(s):

Muhammad Fakhri Ali ◽

Yonas Hadisubroto ◽

Jauhar Firdaus

Keyword(s):

Data Analysis ◽

Mortality Rate ◽

Maternal Mortality ◽

Gestational Age ◽

Maternal Age ◽

Advanced Maternal Age ◽

Severe Preeclampsia ◽

Cross Sectional ◽

Maternal Mortality Rate ◽

Significant Difference

Maternal Mortality Rate (MMR) in Indonesia is still high. The maternal mortality rate continues to rise due to hypertension, one of which is caused by pre-eclampsia and eclampsia. Many factors cause preeclampsia, including advanced maternal age. The purpose of this study was to determine the effect of advanced maternal age during pregnancy with severe preeclampsia and eclampsia in RSD dr. Soebandi Jember. This study used cross sectional approach using 264 samples were divided into two groups, there are pregnant women aged 20-34 years and >34 years. The results of data analysis using Chi Square for severe preeclampsia and obtained p = 0.015 and OR = 2.494, which means there is a significant difference in comparison severe preeclampsia between gestational age of 20-34 years and >34 years. At the age of 20-34 years from 216 samples found 28 people suffering from severe preeclampsia (12.9%). Whereas at the age of mother> 34 years of 48 people found 13 people (27.1%) suffered severe preeclampsia Results of data analysis obtained eclampsia using Fisher and p = 0.554, which means there are no significant differences in comparison eclampsia between gestational age of 20-34 years and >34 years. At the age of 20-34 years from 216 samples found 3 people suffering from eclampsia (1.38%). While at mother age> 34 years from 48 people found 1 person (2.08%) suffered eclampsia.

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695: Gestational age-specific neonatal morbidity among pregnancies complicated by advanced maternal age

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2012.10.033 ◽

2013 ◽

Vol 208 (1) ◽

pp. S292-S293

Author(s):

Amy Valent ◽

Tondra Newman ◽

Aimin Chen ◽

Amy Thompson ◽

Emily DeFranco

Keyword(s):

Gestational Age ◽

Maternal Age ◽

Neonatal Morbidity ◽

Advanced Maternal Age

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Intrauterine Fetal Demise and Postneonatal Death Stratified by Maternal Education Level and Gestational Age [152]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000463692.94445.bb ◽

2015 ◽

Vol 125 ◽

pp. 53S

Author(s):

Bethany Ann Sabol ◽

Jessica Marie Page ◽

Jonathan Snowden ◽

Jennifer Anne Salati ◽

Judith Hyunsuk Chung ◽

...

Keyword(s):

Gestational Age ◽

Maternal Education ◽

Education Level ◽

Fetal Demise ◽

Intrauterine Fetal Demise

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Perinatal Outcome of Twin Pregnancies Complicated by Rupture of Membranes at 13–20 Weeks: Is Selective Termination an Appropriate Management Option?

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1176-0919 ◽

2020 ◽

Vol 41 (04) ◽

pp. e17-e22

Author(s):

Michal Zajicek ◽

Simcha Yagel ◽

Dan Valsky ◽

Moshe Ben-Ami ◽

Yoav Yinon ◽

...

Keyword(s):

Survival Rate ◽

Gestational Age ◽

Neonatal Outcome ◽

Clinical Signs ◽

Expectant Management ◽

Inclusion Criteria ◽

Fetal Demise ◽

Management Group ◽

Gestational Age At Delivery ◽

Twin Pregnancies

Abstract Objective To evaluate the outcome of twin pregnancies that were complicated by rupture of membranes at 13–20 weeks of gestation and were managed by expectant management or by selective termination. Methods A retrospective cohort study of all bichorionic twin pregnancies that were referred to three fetal medicine units between 2001 and 2016, due to rupture of membranes of one sac at 13–20 weeks of gestation. Women without clinical signs of infection who opted for expectant management or selective termination were included. Results 20 patients met the inclusion criteria. 7 of them were managed expectantly and 13 underwent selective termination. In the expectant management group there was one case of fetal demise and two cases of neonatal death, resulting in a survival rate of 79 %. The median gestational age at delivery was 30 weeks. 3 neonates suffered from prematurity-related complications and 2 suffered from oligohydramnios-related orthopedic complications. Following selective termination the survival rate was 50 % (all fetuses that were not reduced), the median gestational age at delivery was 39 weeks, and the neonatal outcome was favorable. The maternal outcome was favorable in both groups. Conclusion Selective termination in twin pregnancies complicated by rupture of membranes at 13–20 weeks has a favorable outcome and should be offered.

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The Association between Advanced Maternal Age and Diagnosis of Small for Gestational Age

American Journal of Perinatology ◽

10.1055/s-0039-1694775 ◽

2019 ◽

Vol 37 (01) ◽

pp. 037-043 ◽

Cited By ~ 2

Author(s):

Anna Palatnik ◽

Sarah De Cicco ◽

Liyun Zhang ◽

Pippa Simpson ◽

Judith Hibbard ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Maternal Age ◽

Advanced Maternal Age ◽

The United States ◽

Age Group ◽

Nulliparous Women ◽

Increased Risk ◽

Multiparous Women ◽

Multivariable Analyses

Abstract Objectives To identify whether advanced maternal age (AMA), defined as age ≥35 years old, is independently associated with small for gestational age (SGA). Study Design This was a retrospective cohort of births from the National Vital Statistics System in the United States from 2009 to 2013. Women were categorized based on four age groups at the time of delivery: 20 to 29, 30 to 34, 35 to 39, and ≥40 years old. The primary outcome of SGA < 10th and SGA < 5th percentiles was compared between the four groups using both univariable and multivariable analyses to determine whether maternal age was associated with SGA independent of parity. Results A total of 17,031,005 births were eligible for analysis, with 2,705,501 births to AMA women. In multivariable analyses, maternal age of 30 to 34, compared with 20 to 29, was associated with lower rates of SGA < 10th and <5th percentiles (adjusted odds ratio [aOR] = 0.95; 95% confidence interval [CI]: 0.95–0.96 and aOR = 0.97; 95% CI: 0.96–0.98, respectively). The AMA of 35 to 39, compared with 20 to 29, was associated with lower rates of SGA < 10th percentile and unchanged rates of SGA < 5th percentile (aOR = 0.97; 95% CI: 0.96–0.98 and aOR = 1; 95% CI: 0.99–1.01, respectively). In contrast, AMA of ≥40, compared with age 20 to 29, was associated with higher rates of both SGA < 10th and <5th percentiles (aOR = 1.06; 95% CI: 1.04–1.07 and aOR = 1.14; 95% CI: 1.12–1.16, respectively). A significant association was found between maternal age and parity toward the risk of SGA (p < 0.001). Nulliparous women ≥30 years old but not multiparous women had higher rates of SGA < 10th and SGA < 5th percentiles compared with nulliparous women in the age group of 20 to 29. In contrast, both nulliparous and multiparous women age ≥40 years old had an increased risk for SGA < 5th percentile compared with all women in the age group of 20 to 29. Conclusion Nulliparous women aged 30 years and older have higher risk of SGA < 10th and SGA < 5th percentiles compared with nulliparous women age 20 to 29. In contrast, both nulliparous and multiparous women age 40 years and older have an increased risk of SGA < 5th percentile compared with all women in the age group of 20 to 29.

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