scholarly journals Maternal advanced age, single parenthood, and ART increase the risk of child morbidity up to five years of age

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Malin Lindell Pettersson ◽  
Marie Bladh ◽  
Elizabeth Nedstrand ◽  
Agneta Skoog Svanberg ◽  
Claudia Lampic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Single Mothers ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Pediatric Care ◽  
Obstetric Outcomes ◽  
Specialist Care ◽  
Cross Sectional ◽  
Outpatient Visits ◽  
Mothers And Children

Abstract Background Advanced maternal age, single status and use of assisted reproductive technology (ART) are increasing in mothers in high-income countries, and all are known risk factors for negative obstetric outcomes. Less is known about their long-term consequences for childhood morbidity. Thus, the aim of this study was to investigate morbidity up to five years of age, in the children of older, single, and/or ART-treated mothers. Methods A cross-sectional using Swedish registers was performed comprising 23 772 children. The prevalence of diagnosis and the number of hospital visits for specialist care, were compared and analyzed in relation to maternal age at childbirth, maternal civil status, and mode of conception. The odds ratio for specialized care within each ICD-chapter were estimated using single and multiple logistic regression. Results Children born to single mothers and children conceived using ART had significantly more outpatient visits for specialist care and significantly more diagnoses compared to children with married/cohabiting mothers, and spontaneously conceived children. Children born to mothers of advanced maternal age (≥40) had fewer in- and outpatient visits. However, they were significantly more often diagnosed within ICD-chapters XVI, XVII i.e., they experienced more morbidity in the neonatal period. Conclusion The results indicate that children born to single mothers and children of ART-treated mothers have a higher morbidity and consume more specialist care than children of married/cohabiting and spontaneously pregnant mothers. We conclude that the use of ART, maternal single status and advanced maternal age are risk factors of importance to consider in pediatric care and when counseling women who are considering ART treatment.

scholarly journals Impact of aging on obstetric outcomes: defining advanced maternal age in Barcelona

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marta Claramonte Nieto ◽  
Eva Meler Barrabes ◽  
Sandra Garcia Martínez ◽  
Mireia Gutiérrez Prat ◽  
Bernat Serra Zantop
Keyword(s):  
Risk Factor ◽  
Gestational Diabetes ◽  
Maternal Age ◽  
Placenta Previa ◽  
Significant Risk ◽  
Advanced Maternal Age ◽  
Obstetric Outcomes ◽  
Chronic Hypertension ◽  
Mediterranean Population ◽  
Confounding Factors

Abstract Background Women of advanced maternal age (AMA) are a growing population, with higher obstetric risks. The Mediterranean population has specific characteristics different from other areas. Thus, the objective of this study was to establish a cut-off to define AMA in a selected mediterranean population coming from a tertiary referral private/mutual health hospital in Barcelona. Methods Retrospective cohort of euploid singleton pregnancies delivered from January 2007 to June 2017. Main maternal outcomes were: gestational diabetes, preeclampsia, placenta previa, c-section and prolonged hospitalization (≥ 7 days). Main adverse perinatal outcomes were: stillbirth, prematurity, preterm prelabor rupture of membranes, low birth weight, need of admission at a neonatal intensive care unit and perinatal mortality. Adjustment for confounding factors (smoking, previous comorbilities, parity, assisted reproductive techniques (ART) and obesity) was performed. Results A total of 25054 pregnancies were included. Mean maternal age was 34.7 ± 4.2 years, with 2807 patients in the group of age between 40 and 44 years (11.2%) and 280 patients ≥45 years (1.1%). Women at AMA had higher incidence of previous comorbilities (compared to the reference group of women < 30 years): prior c-section, chronic hypertension and obesity. In addition, they were more likely to use ART. After adjusting for confounding factors, maternal age was an independent and statistically significant risk factor for gestational diabetes (OR 1.66/2.80/3.14) for ages 30–39, 40–44 and ≥ 45 years respectively, c-section (OR 1.28/2.41/7.27) and placenta previa (OR 2.56/4.83) for ages 40–44 and ≥ 45 years respectively, but not for preeclampsia (neither early-onset nor late-onset). Risk of emergency c-section was only increased in women ≥45 years (OR, 2.03 (95% CI, 1.50–2.74). In the other groups of age, the increase in c-section rate was because of elective indications. Age ≥ 45 years was associated with iatrogenic prematurity < 37 weeks (OR 2.62, 95% CI 1.30–5.27). No other relevant associations between AMA and maternal or neonatal outcomes were found. Conclusions Maternal age is an independent risk factor for adverse obstetric outcomes. Age ≥ 40 years was associated to relevant increased risks and reveals to be an adequate cut-off to define AMA in our population.

scholarly journals Maternal age at first cesarean delivery related to adverse pregnancy outcomes in a second cesarean delivery: a multicenter, historical, cross-sectional cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shilei Bi ◽  
Lizi Zhang ◽  
Jingsi Chen ◽  
Minshan Huang ◽  
Lijun Huang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Cesarean Delivery ◽  
Maternal Age ◽  
Reference Group ◽  
Multivariate Logistic Regression Analysis ◽  
Advanced Maternal Age ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Singleton Pregnancies

Abstract Background To determine the effects of maternal age at first cesarean on maternal complications and adverse outcomes of pregnancy with the second cesarean. Methods This was a multicenter, historical, cross-sectional cohort study involving singleton pregnancies ≥28 gestational weeks, with a history of 1 cesarean delivery, and who underwent a second cesarean between January and December 2017 at 11 public tertiary hospitals in 7 provinces of China. We analyzed the effects of maternal age at first cesarean on adverse outcomes of pregnancy in the second cesarean using multivariate logistic regression analysis. Results The study consisted of 10,206 singleton pregnancies. Women were at first cesarean between 18 and 24, 25–29, 30–34, and ≥ 35 years of age; and numbered 2711, 5524, 1751, and 220 cases, respectively. Maternal age between 18 and 24 years at first cesarean increased the risk of placenta accreta spectrum (aOR, 1.499; 95% CI, 1.12–2.01), placenta previa (aOR, 1.349; 95% CI, 1.07–1.70), intrahepatic cholestasis of pregnancy (aOR, 1.947; 95% CI, 1.24–3.07), postpartum hemorrhage (aOR, 1.505; 95% CI, 1.05–2.16), and blood transfusion (aOR, 1.517; 95% CI, 1.21–1.91) in the second cesarean compared with the reference group (aged 25–29 years). In addition, maternal age ≥ 35 years at first cesarean was a risk factor for premature rupture of membranes (aOR, 1.556; 95% CI, 1.08–2.24), placental abruption (aOR, 6.464, 95% CI, 1.33–31.51), uterine rupture (aOR, 7.952; 95% CI, 1.43–44.10), puerperal infection (aOR, 6.864; 95% CI, 1.95–24.22), neonatal mild asphyxia (aOR, 4.339; 95% CI, 1.53–12.32), severe asphyxia (aOR, 18.439; 95% CI, 1.54–220.95), and admission to a neonatal intensive care unit (aOR, 2.825; 95% CI, 1.54–5.17) compared with the reference group (aged 25–29 years). Conclusions Maternal age between 18 and 24 years or advanced maternal age at first cesarean was an independent risk factor for adverse maternal outcomes with the second cesarean. Advanced maternal age at the first cesarean specifically increased adverse neonatal outcomes with the second. Therefore, decisions as to whether to perform a first cesarean at a young or advanced maternal age must be critically evaluated.

Advanced Maternal Age and Pregnancy Outcome at Manipal Teaching Hospital: Cross-sectional Analytical study

2021 ◽  
Vol 6 (1) ◽  
pp. 20-25
Author(s):  
Vibha Mahato ◽  
Pravin Shrestha ◽  
Pradeep Bhattarai
Keyword(s):  
Caesarean Section ◽  
Postpartum Hemorrhage ◽  
Perinatal Outcome ◽  
Maternal Age ◽  
Analytical Study ◽  
Fetal Distress ◽  
Advanced Maternal Age ◽  
Age Group ◽  
Cross Sectional ◽  
Very Advanced Maternal Age

Introduction: Advanced and very advanced maternal age are associated with several adverse maternal and fetal outcome. The objective of this study was to find out the possible association between advance maternal age and adverse pregnancy outcomes at Manipal Teaching Hospital.Methods: A cross sectional analytical study conducted at department of Obstetrics and Gynecology, Manipal Teaching Hospital, Pokhara, Nepal. A total of 198 patient who were ≥30 years and >24 weeks pregnant admitted in obstetric ward were selected. These patient were divided into three groups according to their age (30-34, 35-39 and ≥ 40years). We compared the incidence of adverse maternal and perinatal outcome among these groups. We also calculated odds ratio of maternal and perinatal outcomes in 35-39 years and ≥ 40years women, compared with women aged 30-34 years.Results: Comparison of the three age groups revealed that advanced maternal age constitute a predisposing factor for malpresentation, gestational diabetes mellitus, placenta previa, fetal distress and caesarean section. Whereas, risk of non progress of labour, preterm birth, postpartum hemorrhage, perinatal death and congenital anomalies were increased in very advanced maternal age group. From these, statistical significance was reached in case of greater risk of malpresentation (p=0.01,OR=6.66), fetal distress (p=0.04, OR=2.6) and caesarean section(p=0.02,OR=2.06) in advanced age group when compared to the patients aged 30-34. Furthermore, very advanced age group were higher risk of postpartum hemorrhage (p=0.03, OR=2.47) and congenital anomalies, which were statistically significant (p=0.04, OR=29.57) when compared to the 30-34 years.Conclusion: Advanced and very advanced maternal age is associated with several adverse maternal and perinatal outcome. The risk of perinatal complication begin to increase after the age of 35 but significantly increased after 40 years.

scholarly journals Maternal Risk Factors of Placenta Praevia and Its Effects on Maternal and Fetal Outcome

2019 ◽  
Vol 48 (2) ◽  
pp. 7-12
Author(s):  
Alpana Adhikary ◽  
Anwara Begum ◽  
Fahmida Sharmin Joty ◽  
Nihar Ranjan Sarker ◽  
Rifat Sultana
Keyword(s):  
Risk Factors ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Fetal Outcome ◽  
Placenta Praevia ◽  
Maternal Risk Factors ◽  
High Parity ◽  
Maternal Risk ◽  
Antepartum Haemorrhage ◽  
History Of

Placenta praevia is one of the most serious obstetric emergencies, which continues to be an important contributor to perinatal mortality and is responsible for leading maternal and infant morbidity. Very few data on etiology of placenta praevia are available till now. This study aims to explore the maternal risk factors related to occurrence of placenta praevia and its effects on maternal and fetal outcome. This cross-sectional observational study was carried out among 3279 obstetrics patients admitted in labour ward in the Department of Obstetrics and Gynecology, Sher-e-Bangla Medical College Hospital from January to December 2006. Out of 3279 obstetrics patients 93 placenta praevia cases were identified purposively as study subjects. The patients of placenta praevia were selected either diagnosed clinically by painless antepartum haemorrhage or asymptomatic placenta praevia diagnosed by ultrasonography irrespective of age, gestational age, parity, booking status. Pregnant woman admitted with painful antepartum haemorrhage were excluded from the study. With the ethical approval from the Institutional Ethical Committee (IEC), patients were selected after taking their written consent. A structured questionnaire and a chick list were designed with considering all the variables of interest. Out of 93 respondents, 73.88% were associated with risk factors in addition to advanced maternal age and high parity. Among them 24.73%, 33.33% and 7.52% had history of previous caesarean section (CS), MR and abortion and both CS & abortion previously. Patients aged above 30 years were 47% and 35.48% were in their 5th gravid and more; whereas, 31.18% patients were asymptomatic, 68.82% patients presented with varying degree of vaginal bleeding, among them 12.08% were in shock. Active management at presentation was done on 76.34% patients and 23.66% were managed expectantly. CS was done o 82.79% patients and only 17.2% were delivered vaginally. Case fatality rate was 1.07% and about 22% perinatal death was recorded, majority belonged to low birth weight (<1500 gm). About 10% patients required caesarean hysterectomy, 3.22% required bladder repair. Advanced maternal age, high parity, history of previous CS and abortion found to be common with the subsequent development of placenta praevia. Proper diagnosis, early referral and expectant management of patients will reduce prematurity, thereby improvised foetal outcome but to improve maternal outcome rate of primary CS have to be reduced and increase practice of contraception among women of reproductive age. Bangladesh Med J. 2019 May; 48 (2): 7-12

scholarly journals A study of low birth weight prevalence and risk factors among newborns in a public-hospital at Kilis, Turkey

2020 ◽  
Vol 20 (2) ◽  
pp. 709-714
Author(s):  
Hasan Hüseyin Çam ◽  
Muazzez Harunoğulları ◽  
Yadigar Polat
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Maternal Age ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Important Indicator ◽  
Maternal Risk ◽  
Syrian Refugee

Background: Low birth weight (LBW) is an important indicator of reproductive health and general health status of population. Objectives: The present study was aimed to estimate the prevalence of low birth weight (LBW), and to investigate the associations between some risk factors and LBW in Syrian refugee and Turkish population in Kilis, Turkey. Methods: The population of this study constituted of a total of 4379 infants born in Kilis State Hospital in 2016 using a retrospective cross-sectional study design. The data were collected from birth records. The data were analyzed using SPSS version 16.0. Binary logistic regression analysis was performed to identify predictors of low birth weight. Factors with a p-value < 0.05 were deemed to be statistically significant. Results: The prevalence of LBW was 6.7% in all groups. Significant relationships were found between young maternal age, Syrian refugee mother, female infants, cesarean delivery and LBW. Conclusion: The prevalence of low birth weight in the study area was comparatively lower than that of countrywide figure. Maternal related variables like, maternal age, mother's nationality, and mode of birth (vaginal, cesarean) take after up as well as new-born related variables like gender of the neonate were significantly related with low birth weight. Keywords: Low birth weight; maternal; risk factors,; prevalence.

scholarly journals Risk Factors Affecting the Severity of Full-Term Neonatal Retinal Hemorrhage

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Zhang Yanli ◽  
Zhao Qi ◽  
Lin Yu ◽  
Guo Haike
Keyword(s):  
Risk Factors ◽  
Intracranial Hemorrhage ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Retinal Hemorrhage ◽  
Full Term ◽  
Term Infants ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Prolonged Duration

Objective. The purpose of this study was to explore the underlying clinical factors associated with the degree of retinal hemorrhage (RH) in full-term newborns. Methods. A total of 3054 full-term infants were included in this study. Eye examinations were performed with RetCamIII within one week of birth for all infants. Maternal, obstetric, and neonatal parameters were compared between newborns with RH and controls. The RH group was divided into three sections (I, II, and III) based on the degree of RH. Results. RH was observed in 1202 of 3054 infants (39.36%) in this study. The quantity and proportion of newborns in groups I, II, and III were 408 (13.36%), 610 (19.97%), and 184 (6.03%), respectively. Spontaneous vaginal delivery (SVD), prolonged duration of second stage of labor, advanced maternal age, and neonatal intracranial hemorrhage positively correlated with aggravation of the degree of RH in newborns. Conversely, cesarean section was protective against the incidence of RH. Conclusions. SVD, prolonged duration of second stage of labor, advanced maternal age, and neonatal intracranial hemorrhage were potential risk factors for aggravation of the degree of RH in full-term infants. Accordingly, infants with these risk factors may require greater attention with respect to RH development.

scholarly journals RISK FACTORS FOR PREMATURE BIRTH IN INDONESIA

2021 ◽  
Vol 10 (1) ◽  
pp. 61
Author(s):  
Hafiza Ajeng Dianing Sukma ◽  
Sagar Tiwari
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Child Health ◽  
Maternal And Child Health ◽  
Premature Birth ◽  
Maternal Age ◽  
Smoking Habits ◽  
Cross Sectional ◽  
Neonatal Deaths ◽  
And Child Health

Indonesia is currently taking on the challenge of the relatively high number of neonatal deaths influencing maternal and child health. Premature birth is the most significant contributor to the number of neonatal deaths. The occurrence of premature birth is motivated by various risk factors. Knowing the magnitude of the relationship between several risks, namely maternal age, location, parity, and maternal smoking habits with preterm birth incidents was the aim of this study. The 2017 Indonesian Demographic and Health Survey (IDHS) was a source of data used. This study employed a cross-sectional approach and then processed the results with univariate and bivariate tests. The results showed a relationship between maternal age and residential area with the premature birth, where mothers under 20 years and over 35 years had a higher probability of giving birth prematurely. The area of residence, which was divided into rural and urban, also had a relationship with premature birth. The parity and smoking habits showed no association with preterm birth. Education, Antenatal Care (ANC), and other various efforts to emphasize maternal and child health care during pregnancy need to be continuously improved to reduce preterm birth rates in Indonesia.

scholarly journals A study of birth defects in a tertiary care teaching hospital at Chennai, India

2017 ◽  
Vol 6 (7) ◽  
pp. 3067
Author(s):  
Mangalageetha Amirthalingam ◽  
Padmalatha Dakshnamurthy ◽  
Vinodhini Shanmugham
Keyword(s):  
Risk Factors ◽  
Birth Defects ◽  
Teaching Hospital ◽  
Congenital Anomalies ◽  
Maternal Age ◽  
Tertiary Care ◽  
Maternal Diabetes ◽  
Advanced Maternal Age ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching

Background: The Congenital anomalies were estimated to be the fifth largest cause of neonatal deaths in India. The purpose of our study was to determine the proportion and pattern of congenital anomalies and their association with risk factors like maternal diabetes, advanced maternal age and consanguinity among the babies born in a tertiary care teaching hospital in Chennai.Methods: This study is a cross sectional descriptive study where all the newborns including still born delivered with the presence of congenital anomalies and those fetuses terminated due to detection of presence of congenital anomalies were analyzed. The study was done at the OBG department in a tertiary care center for a period of one year 1st June 2015 to 31st May 2016.Results: The overall incidence of birth defects were 2.36%, of which musculo skeletal defects (18.88%) were commonly found. There was a definite correlation of risk factors with consanguinity showing an incidence of 1.5 times the overall incidence of birth defects (3.54%) and maternal diabetes mellitus was 6 times the total incidence (15.3%). The correlation between the incidence of birth defects and advanced maternal age was not statistically significant in our study.Conclusions: The study depicts the risk of occurrence of congenital anomalies in the presence of maternal diabetes and in consanguineous marriage and emphasizes on the necessity of adequate screening like first trimester and second trimester ultrasonogram for the early detection of anomalies in the fetus especially if these risk factors are present in the mother.

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