The implications for advanced maternal age on pregnancy complications and adverse neonatal outcomes

Objective This study aimed to determine the effect of advanced maternal age (AMA) on maternal and neonatal outcomes in pregnant women aged ≥35 years compared with patients aged 30–34 years. Also, we aimed to analyze the risk estimates of potential confounders to identify whether these variables contributed to the development of adverse pregnancy outcomes or not. Methods This retrospective cohort study included 2284 pregnant women aged ≥35 years at the time of delivery who was delivered in a tertiary referral hospital from January 1, 2016, to December 31, 2020. We further classified these women into two subgroups: 35–39 years as early AMA (EAMA), and ≥40 years as very AMA (VAMA). Pregnancy complications and adverse neonatal outcomes were recorded. Results Compared to younger women, pregnant AMA women had significantly higher risks of complicated pregnancies, including a higher risk of gestational diabetes mellitus (GDM, p<0.001), polyhydramnios (p<0.001), cesarean section (p<0.001), stillbirths (p<0.001), major fetal abnormality (p<0.001), preterm delivery (p<0.001), lower birth weight (p<0.001), lower 5-minute Apgar scores (p<0.001), lower umbilical artery blood pH values (p<0.001), neonatal intensive care unit (NICU) admission (p<0.001), and length of NICU stay (p<0.001). Conclusion We found a strong and significant association between VAMA and adverse pregnancy outcomes, including an increased risk of GDM, polyhydramnios, cesarean section, and adverse neonatal outcomes, including a higher risk of stillbirths, preterm delivery, lower birth weight, lower 5-minute Apgar scores, and NICU admission.

Download Full-text

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

Current Women s Health Reviews ◽

10.2174/1573404816999201009160848 ◽

2020 ◽

Vol 16 ◽

Author(s):

Reza Omani-Samani ◽

Saman Maroufizadeh ◽

Nafise Saedi ◽

Nasim Shokouhi ◽

Arezoo Esmailzadeh ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Cesarean Section ◽

Pregnant Women ◽

Maternal Age ◽

Unwanted Pregnancy ◽

Advanced Maternal Age ◽

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

Download Full-text

Risks of Selected Fetal Adverse Pregnancy Outcomes at Advance Maternal Age

10.53350/pjmhs211582468 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2468-2471

Author(s):

Saadia Yasmeen ◽

Sumayya . ◽

Javeria Saleem ◽

Jawairiah Liaqat ◽

Nadia Pervaiz ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Advanced Maternal Age ◽

Adverse Pregnancy Outcomes ◽

Control Group ◽

Postpartum Women ◽

Adverse Pregnancy

Background and Aim: Advanced maternal age pregnancy could be referred to as pregnancy after 35 years or older. The prevalence of postponing pregnancies is increasing day by day worldwide. However, limited evidence was found on advanced maternal age pregnancy association with fetal adverse outcomes. The present study aimed to evaluate the frequency of advanced maternal age selected fetal adverse pregnancy outcomes. Place and Duration: Obstetrics & Gynaecology department of Alkhidmat Hospital Kohat and Qazi Hussain Ahmad Medical Complex, Nowshera for duration of six months from November 2020 to April 2021. Materials and Methods: This single-centered retrospective study was conducted on 220 postpartum women in the study group (≥35 years) and 170 control group postpartum women (20-34 years) who delivered at Obstetrics & Gynaecology department of Alkhidmat Hospital Kohat and Qazi Hussain Ahmad Medical Complex, Nowshera after 28 gestational weeks. Individuals who met the inclusion criteria were enrolled and sampled based on randomized control sampling technique for both control and study groups. Data extraction checklist and pretested questionnaire were used for data collection from the maternal charts. Adverse pregnancy outcome and advanced maternal age was correlated adjusted relative risks and strength with a 95% confidence interval. SPSS version 20 was used for data analysis and considered p-value >0.05 as a statistical standard. Results: The adverse neonatal outcomes include low birth weight, preterm birth, and stillbirth with a prevalence 38 (17.4%), 46 (20.8%), and 31 (14.2%) respectively in the study group. In the control group, the incidence of low birth weight, preterm birth, and stillbirth was 21 (12.6%), 15 (14.6%) and 6 (3.5%) respectively. The stillbirth (ARR=3.16 95% CI (1.29–6.03) and preterm deliveries (ARR=2.71 95% CI (1.79–3.86) risk had significantly higher prevalence compared to control group advanced age pregnancy. Insignificance association was found between low birth weight and advanced maternal age. Conclusion: Stillbirth and preterm birth was the adverse fetal outcome significantly related with advanced maternal age pregnancy. There was no significant association between low birth weight and advanced maternal age. Keywords: Maternal age, Fetal Adverse Pregnancy Outcomes

Download Full-text

Risk of Selected Fetal Adverse Pregnancy Outcomes at Advanced Maternal Age: A Retrospective Cohort Study in Debre Markos Referral Hospital, Northwest Ethiopia

Obstetrics and Gynecology International ◽

10.1155/2020/1875683 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Bikila Tefera Debelo ◽

Melaku Hunie Asratie ◽

Abayneh Aklilu Solomon

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Advanced Maternal Age ◽

Referral Hospital ◽

Age Group ◽

Debre Markos ◽

Adverse Pregnancy

Introduction. Pregnancy at an advanced maternal age is defined as pregnancy at 35 years or older. Today, women postpone pregnancy due to different socioeconomic and personal reasons. However, there was limited evidence on fetal adverse outcomes’ association with pregnancy at an advanced maternal age in Ethiopia and particularly in the study area. This study was aimed at assessing the effect of pregnancy at an advanced age on selected neonatal adverse pregnancy outcomes in Debre Markos Referral Hospital, Ethiopia, 2019. Methods. Institution-based retrospective cohort study was conducted on 303 exposed (35 years and older) and 604 nonexposed (20–34 years old) immediate postpartum women who delivered at Debre Markos Referral Hospital after 28 weeks of gestation. All exposed women who fulfilled the inclusion criteria were sampled, and systematic random sampling was employed for those in the nonexposed group. The data were collected from 1st of July to 30th of December, 2019, by face-to-face interview and extraction from maternal chart using a structured questionnaire and data extraction checklist, respectively. Binary logistic regression (bivariate and multivariable) model was fitted, and wealth index was analyzed by principal component analysis. Adjusted relative risk with respect to 95% confidence interval was employed for the strength and directions of association between advanced maternal age and selected adverse pregnancy outcomes, respectively. P -value of <0.05 was used to declare statistical significance. Results. The incidence of adverse neonatal outcomes including stillbirth, preterm birth, and low birth weight in the advanced maternal age group was 13.2%, 19.8%, and 16.5%, respectively. The incidence of stillbirth, preterm birth, and low birth weight in the nonexposed group was 3.1%, 8.4%, and 12.4%, respectively. The advanced maternal age group had three times the risk of stillbirth compared with the nonexposed group (ARR = 3.14 95% CI (1.30–7.00)). The advanced maternal age group had 2.66 times the risk of delivering preterm fetus (ARR = 2.66 95% CI (1.81–3.77)) compared with the younger counterparts. Low birth weight was not significantly associated with pregnancy at an advanced maternal age. Conclusion. Fetal adverse outcomes including stillbirth and preterm birth were significantly associated with pregnancy at an advanced maternal age.

Download Full-text

Advanced maternal age and adverse pregnancy outcomes: A cohort study

Taiwanese Journal of Obstetrics and Gynecology ◽

10.1016/j.tjog.2020.11.018 ◽

2021 ◽

Vol 60 (1) ◽

pp. 119-124

Author(s):

M. Guarga Montori ◽

A. Álvarez Martínez ◽

C. Luna Álvarez ◽

N. Abadía Cuchí ◽

P. Mateo Alcalá ◽

...

Keyword(s):

Cohort Study ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Advanced Maternal Age ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

Download Full-text

Risk of Adverse Pregnancy Outcomes at Advanced Maternal Age

Obstetrics and Gynecology ◽

10.1097/aog.0000000000002504 ◽

2018 ◽

Vol 131 (3) ◽

pp. 457-463 ◽

Cited By ~ 34

Author(s):

Line Elmerdahl Frederiksen ◽

Andreas Ernst ◽

Nis Brix ◽

Lea Lykke Braskhøj Lauridsen ◽

Laura Roos ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Maternal Age ◽

Advanced Maternal Age ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

Download Full-text

Risk of Adverse Pregnancy Outcomes at Advanced Maternal Age

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000542378.64975.41 ◽

2018 ◽

Vol 38 (3) ◽

pp. 155

Author(s):

L.E. Frederiksen ◽

A. Ernst ◽

N. Brix ◽

L.L. Braskhøj Lauridsen ◽

L. Roos ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Maternal Age ◽

Advanced Maternal Age ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

Download Full-text

Study of pregnancy outcome in elderly gravida

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175247 ◽

2017 ◽

Vol 6 (12) ◽

pp. 5384

Author(s):

Pratibha V. Dixit ◽

Madhuri A. Mehendale

Keyword(s):

Maternal Age ◽

Pregnancy Termination ◽

Later Life ◽

Advanced Maternal Age ◽

Health Concern ◽

Demographic Shift ◽

Utmost Care ◽

Adverse Pregnancy ◽

Nicu Admission ◽

And Control

Background: Elderly gravida which is defined as age of mother as 35 years or more at the time of delivery has become increasingly common in last two to three decades. This accelerating demographic shift is of major clinical and public health concern, because advanced maternal age has consistently been associated with adverse pregnancy outcomes.Methods: An observational prospective study consisting of 120 pregnant women. All participants were divided into Study group and Control group.Results: Women of advanced maternal age have higher frequency of antenatal complications leading to early pregnancy termination and operative interference. There is significant increase in the incidence of adverse perinatal outcome due to preterm deliveries and NICU admission and neonatal death.Conclusions: With improved health services and better prospects of women who are >35 years of becoming pregnant, these pregnancies are fraught with complications. Women should realistically appraise the risks of pregnancy in later life. Hence these women should be counselled, and their complications managed with utmost care.

Download Full-text