Maternal age and adverse perinatal outcomes in a birth cohort (BRISA) from a Northeastern Brazilian city

Figueredo, Eduardo; Filho, Fernando Lamy; Lamy, Zeni Carvalho; Silva, Antônio Augusto Moura da

doi:10.1590/so100-720320140005161

Cited by 16 publications

(18 citation statements)

References 26 publications

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“…However, in accordance with Vienne et al (2), these associations were not significant after adjusting for confounding variables. The results of studies related to the association of teenage pregnancy and IUGR are contradictory (11,12); in fact, some of them were not adjusted for confounding factors. We observed a lower incidence of intrauterine growth restriction in teenage pregnancy, especially in the older adolescent group.…”

Section: Discussionmentioning

confidence: 99%

“…In low-and middle-income countries, pregnancy has been reported as the main factor of death in adolescent girls (1). Young maternal age has usually been considered a high risk in relation to adverse pregnancy outcomes (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Possible explanations for adverse pregnancy outcomes have been thought to be their biological immaturity or poor social, economic and behavioral factors such as smoking, alcohol/substance abuse, malnutrition and inadequate prenatal care (17)(18)(19)(20)(21)(22).…”

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confidence: 99%

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Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from the Tertiary Center in Turkey

et al. 2016

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Background: Young maternal age is variously defined in studies of its effect on obstetrics and perinatal outcomes. Also, pregnancy has been reported as the leading cause of death in adolescent girls in low-and middle-income countries. Aims: The aim of the study was to evaluate whether young maternal age was associated with an increased risk of obstetrics and perinatal adverse outcomes. Study Design: Case-control study. Methods: This case-control study was derived from a database of the medical records between January 2008 and December 2012. In the present study, 1374 teenage pregnancy and 1294 adult pregnancy cases were included. After restriction of analyses to singleton primiparous women, 1282 teenage pregnancy and 735 adult pregnancy cases were analyzed. Maternal age was separated into three groups: 15 and less, 16-19, and 20-34 years. Adjusted odds ratios (ORs) were derived through logistic regression models for the potential confounding factors. Results: Adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine fetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors. In addition, both groups of adolescents had higher risks for anemia and episiotomy and lower risk of cesarean delivery. The rates of preeclampsia, gestational diabetes, chronic diseases, intrauterine growth restriction (IUGR) were higher in the adult group. Adolescent pregnancy is defined as pregnancy in girls aged less than 20 years. It is estimated that 16 million 15-19 yearold women give birth every year, accounting for approximately 11% of all births worldwide (1). In low-and middle-income countries, pregnancy has been reported as the main factor of death in adolescent girls (1). Young maternal age has usually been considered a high risk in relation to adverse pregnancy outcomes (1-16). Possible explanations for adverse pregnancy outcomes have been thought to be their biological immaturity or poor social, economic and behavioral factors such as smoking, alcohol/substance abuse, malnutrition and inadequate prenatal care (17-22). However, the previous studies had conflicting findings regarding whether the effect of young maternal age on adverse pregnancy outcomes were caused by their biological immaturity or poor social, economic and behavioral factors (17)(18)(19)(20)(21)(22). ConclusionThe aim of the present study was to investigate whether there is an association between young maternal age and poor maternal and perinatal outcomes independent of possible confounding factors.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from the Tertiary Center in Turkey

et al. 2016

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“…9,10 For most authors, the definition of advanced maternal age (AMA) is 35 years and above. [11][12][13][14] However, in medical literature AMA is often defined as age over 40 years. 10,[15][16][17] Most studies conclude that pregnancy at advanced age is seldom without risks.…”

Section: Introductionmentioning

confidence: 99%

Advanced Maternal Age: Adverse Outcomes of Pregnancy, A Meta-Analysis

et al. 2019

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Introduction: The risks of pregnancy in women of advanced maternal age are not consensual amongst studies. The aim of this metaanalysis was to determine whether women of advanced maternal age (≥ 35 years old) had worse obstetrical and perinatal outcomes than non- advanced maternal age women (20 - 34 years old) in singleton, naturally-conceived pregnancies.Material and Methods: We searched PubMed/ MEDLINE, IndexRMP and the Cochrane Database of Systematic Reviews. Ten studies were included according to the following criteria: population of > 1000 nulliparous and/or multiparous women with singleton gestations who did not undergo any type of infertility treatment. Using Review Manager v. 5.3, two meta-analysis were performed: one comparing the outcomes of 20 - 34-year-old vs 35 - 40-year-old women, and another comparing the outcomes of 35 - 40-year-old women vs > 40-year-old women.Results: Women aged 35 - 40 years old were more likely to have > 12 years of education than 20 - 34 years old and > 40 years old women. Advanced maternal age women (35 - 40 and > 40 years old) were more likely to be overweight and having gestational diabetes and gestational hypertension. They were also more likely to undergo induced labour and elective caesarean deliveries. Furthermore, they had worse perinatal outcomes such as preterm delivery, low birthweight babies, higher rates of Neonatal Intensive Care Unit admission and worse Apgar scores. Advanced maternal age women had higher rates of perinatal mortality and stillbirth.Discussion: Most authors present similar results to our study. Although the majority of adverse outcomes can be explained through the physio-pathological changes regarding the female reproductive apparatus that come with aging and its inherent comorbidities, according to the existing literature advanced maternal age can be an independent risk factor per se. In older pregnant women without comorbidities such as gestational hypertension or diabetes there are still worse obstetric and perinatal outcomes, which indicate that advanced maternal age is an independent strong risk factor alone.Conclusion: Advanced maternal age women are at a higher risk of adverse obstetrical and perinatal outcomes. In both comparisons, worse outcomes were more prevalent in the older group, suggesting that poorer outcomes are more prevalent with increasing age.

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“…In this study, the status of advanced maternal age was 29.5%( 95%CI: 26.1%, 32.8%). This was higher than studies conducted in Israel (2.3% and 14%) [4,10], Malaysia (14.8%) [14], WHO Multicountry Survey (12.8%) [9], Northeastern Brazil (5.9%) [13], Nepal (4.53%) [15], South Africa (17.5%) [16], and United Kingdom (18.18%) [17]. However, it was lower than studies done in Iran (50.2%) [29], and Norway (33.4%) [11].…”

Section: Association Of Maternal Age With Adverse Obstetric Outcomesmentioning

confidence: 59%

“…In the last four decades, the rate of pregnancy in older women has increased [8]. Different studies which were conducted in Iran, Jerusalem, Israel; multi-country study; Norway; Asia; Muar district, Johor, Malaysia, Northeastern Brazilian city and cohort study in Israel showed that the incidence of pregnant women with advanced maternal age was 49.8%, 14%, 12.3%, 33.4%, 11.4-19.1%, 14.8%, 5.9% and 2.3% respectively [4,[9][10][11][12][13][14]. Similarly, other studies reported 4.53% from Nepal, 17.5% from South Africa, and 19.1% from the UK by North Western Perinatal Survey; which was a large contemporary cohort study [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Adverse Obstetric Outcomes at Advanced Maternal Age in Arba Minch Zuria, and Gacho Baba District, Southern Ethiopia: A Prospective Cohort Study

Mersha¹,

Ayele²,

Worku³

et al. 2020

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Background: Advanced maternal age significantly increased the risk of adverse obstetric outcomes. So, adequate and updated information on the status of advanced maternal age and their effect on obstetric outcomes is vital for effective policy and program formulation in Ethiopia. Pockets of studies conducted, but most are retrospective and record reviews. Thus, studies that show the status of advanced maternal age and their effect on obstetric outcomes is very limited in Ethiopia. As such, this study fills those gaps in our set up.Methods: A community-based prospective cohort study was conducted among 709 study participants from October 15, 2018, to September 30, 2019. A pretested interviewer-administered structured Open Data Kit survey tool was used to collect the data. The downloaded data from the Open Data Kit aggregate was exported to SPSS version 25 for analysis. Log-linear regression was used to compare obstetric outcomes among women aged 20–34 years and ≥ 35 years. The model was adjusted for educational and occupational status, party, wealth index, body mass index, household food insecurity, habits, distance to health care institution, and sex of the neonate, antenatal care, postnatal care, and place of delivery. The model fitness was tested by the log-likelihood ratio.Results: In this study, 209(29.5%) of the women were aged ≥ 35 years, and 500(70.5%) aged 20–34 years. Women aged ≥ 35 years were at increased risk of miscarriage (β = 0.29, 95%CI: 0.02, 0.56), and hypertensive disorder (β = 0.07, 95%CI: 0.004, 0.13).Conclusions: Advanced maternal age was independently associated with miscarriage and hypertensive disorder after controlling for possible cofounders. As such, different intervention programs should be designed to create awareness and to provide counseling services for women with advanced age or delayed childbearing.Plain English summaryWomen who bear a child at the age of ≥35 years old are stated as advanced maternal age. At this age, the risk of different obstetric complications is increased. This study was aimed to assess the effect of advanced maternal age on obstetric outcomes in the study settings.A prospective follow-up study was conducted among pregnant women during the study period. The women were followed from the time pregnancy was confirmed up to the immediate postpartum period. Seven hundred forty-four women were interviewed in the baseline and 24 participants became lost to follow-ups during the follow-up period, and 11 excluded from the analysis because of incomplete information.Of the study participants, 209 of the women were beard children at the age of ≥35 years (advanced maternal age), and 500 were age group from 20-34 years old.This study found that advanced maternal age increased risk of miscarriage (termination of pregnancy before fetal viability) and hypertensive disorder during pregnancy, the intrapartum and immediate postpartum period after controlled for possible confounders.In brief, this study showed that a significant number of women became pregnant during advanced maternal age. Therefore, different strategies should be designed for the women who planned to bear child, and information should be provided for women who are advanced age or delayed childbearing to alert them.

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Maternal age and adverse perinatal outcomes in a birth cohort (BRISA) from a Northeastern Brazilian city

Cited by 16 publications

References 26 publications

Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from the Tertiary Center in Turkey

Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from the Tertiary Center in Turkey

Advanced Maternal Age: Adverse Outcomes of Pregnancy, A Meta-Analysis

Adverse Obstetric Outcomes at Advanced Maternal Age in Arba Minch Zuria, and Gacho Baba District, Southern Ethiopia: A Prospective Cohort Study

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