Demographic profile and pregnancy outcomes of adolescents and older mothers in Saudi Arabia: analysis from Riyadh Mother (RAHMA) and Baby cohort study

Fayed, Amel; Wahabi, Hayfaa; Mamdouh, Heba; Kotb, Reham E.; Esmaeil, Samia

doi:10.1136/bmjopen-2017-016501

Cited by 29 publications

(45 citation statements)

References 40 publications

(39 reference statements)

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“…join age was not similar to the threshold age after which the risk of specific adverse outcomes started to increase statistically significantly as compared with the reference age. Our results were in line with those of previous studies on the effect of maternal age (analyzed by age groups), and the risks of adverse pregnancy and birth outcomes increased in both younger (<20 years) 12,13 and older (≥35 years) mothers. [14][15][16] Therefore, there is good reason to believe that most of our results for the association of adolescent and advanced maternal age with adverse pregnancy outcomes are applicable to other reports.…”

Section: Ta B L E 1 the Baseline Characteristics In Primiparasupporting

confidence: 92%

Changing trends of adverse pregnancy outcomes with maternal age in primipara with singleton birth: A join point analysis of a multicenter historical cohort study in China in 2011‐2012

Zhang

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Adverse pregnancy outcomes are related to two opposite maternal factors, youth and aging. However, the change in trend of specific outcomes with childbearing age is unknown. The aim of this study was to investigate the changing trend of various maternal and neonatal outcomes with maternal age from 17 to 44 years. Material and methods Data were extracted from the medical records from 2011‐2012 of 39 public hospitals of 14 cities in China. The eligibility criteria were primiparity and singleton birth. Join point regression analysis was used to estimate the percent change per year of age (PCA) to explore the trends of adverse pregnancy outcomes with regard to maternal age and to identify the join point of maternal age when the trend was changed. Results A total of 89 171 women were eligible for analysis. There were four categories of trend styles. Continuously increasing trends were linear for placenta previa (PCA, 0.1%), placenta implantation (PCA, 0.09%) and postpartum hemorrhage (PCA, 0.22%), and nonlinear for gestational diabetes mellitus with one join point of 23 years (PCA, 0.17% and 0.71%) and cesarean section with four join points of 25, 28, 31 and 36 years (PCA, 1.39%, 0.34%, 1.51%, 3.49% and 0.94%). Continuously decreasing trends were linear for intrahepatic cholestasis (PCA, −0.02%) and nonlinear for anemia with one join point of 28 years (PCA, −0.49% and −0.04%). The bidirective trends were downward to upward for preterm birth (PCA, −2.93%, −0.36% and 0.38%), hypertension in pregnancy (PCA, −0.09%, 0.47%), low birthweight (PCA 0.51% and 0.38%), low 1‐minute Apgar score (PCA, −0.28% and 0.07%), low 5‐minute Apgar score at (PCA, −0.10% and 0.06%) and neonatal intensive care unit admission (PCA, −1.92%, −0.07% and 0.12%) with a nadir age of 28 years. The bidirective trend was upward to downward for macrosomia (PCA, 0.39% and −0.11%), with a peak age of 30 years. Conclusions The changes in the trend of specific outcomes were different with maternal age, which means that youth, aging or both could affect the outcomes.

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Section: Ta B L E 1 the Baseline Characteristics In Primiparasupporting

confidence: 92%

Changing trends of adverse pregnancy outcomes with maternal age in primipara with singleton birth: A join point analysis of a multicenter historical cohort study in China in 2011‐2012

Zhang

et al. 2019

Acta Obstet Gynecol Scand

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“…The BW increased faster from age 20 until age 23 than from age 24 until age 34. The curve was consistent with the ndings of the previous studies [12,14]. But no research provided the threshold maternal age on BW was 34 years old [12,20,21].…”

Section: Discussionsupporting

confidence: 90%

“…Previous studies indicated that the relationship between maternal age and birth weight was inconsistent [4,12,[14][15][16]. Most of the previous studies focused on the incidence of LWB and macrosomia in different age groups by xed classi cation of maternal age [14,16], which might underestimate age-related risk for women in younger age groups and overestimate risks for mothers in older age groups [17]. There is no su cient evidence to assess the appropriateness of using this arti cial traditional age classi cation to assess their impacts on BW.…”

Section: Introductionmentioning

confidence: 99%

Changing trends of birth weight with maternal age: a cross-sectional study in Xi'an city of Northwestern China

Wang

Yang

Shang

et al. 2020

Preprint

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Background: Most studies have shown that maternal age is associated with birth weight. However, the specific relationship between each additional year of maternal age and birth weight remains unclear. The study aimed to analyze the specific association between maternal age and birth weight. Methods: Raw data for all live births from 2015 to 2018 were obtained from the Medical Birth Registry of Xi’an, China. A total of 490143 mother-child pairs with full-term singleton live births and the maternal age ranging from 20 to 40 years old were included in our study. Birth weight, gestational age, birth date of the newborns, maternal birth date, residence and ethnicity were collected. Generalized additive model and two-piece wise linear regression model were used to analyze the specific relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia. Results: The relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia were nonlinear. Birth weight increased 16.204 g per year when maternal age is less than 24 years old (95%CI: 14.323, 18.086), and increased 12.051g per year when maternal age ranged from 24 to 34 years old (95%CI: 11.609, 12.493), then decreased 0.824g per year (95% CI: -3.112, 1.464). The risk of low birth weight decreased with the increase of maternal age until 36 years old (OR= 0.917, 95%CI: 0.903, 0.932 when maternal age younger than 27 years old; OR= 0.965, 95%CI: 0.955, 0.976 when maternal age ranging from 27 to 36 years old), then increased when maternal age older than 36 years old (OR=1.133, 95%CI: 1.026, 1.250). The risk of macrosomia increased with the increase of maternal age (OR=1.102, 95%CI: 1.075, 1.129 when maternal age younger than 24 years old; OR=1.065, 95%CI: 1.060, 1.071 when maternal age ranged from 24 to 33 years old; OR=1.029, 95%CI: 1.012, 1.046 when maternal age older than 33 years old). Conclusions: For women of childbearing age (20-40 years old), the threshold of maternal age on low birth weight was 36 years old, and the risk of macrosomia increased with the increase of maternal age.

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“…Environmental exposures included smoking and secondhand smoking [49,56], and all six studies on anthropometric measures were on BMI (Table 1 and see Additional file 3: Table S2). [47,50,53,54,83,111,113], and maternal anemia in three cohort studies [50,104,113]. Postpartum depression was explored in only one prospective cohort study in the UAE [76].…”

Section: Other Exposuresmentioning

confidence: 99%

“…Summary of the reviewed 81 published cohort studies according to the measured six exposure and two outcome domainsSociodemographic exposuresMaternal age was a common measured sociodemographic exposure studied in 18 cohort studies. Advanced maternal age was associated with GDM, CS, and preterm delivery[51,53,58,92,111,113]. Primary education or less was independently associated with 69% lower likelihood of exclusive breastfeeding at 6 months (aOR, 0.31; 95% CI, 0.11-0.88)[58] (see Additional file 3:Table S2).…”

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confidence: 99%

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

et al. 2020

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Background: We systematically reviewed and chronicled exposures and outcomes measured in the maternal and birth cohort studies in the Gulf Cooperation Council (GCC) countries and quantitatively summarized the weighted effect estimates between maternal obesity and (1) cesarean section (CS) and (2) fetal macrosomia. Methods: We searched MEDLINE-PubMed, Embase, Cochrane Library, Scopus, and Web of Science electronic databases up to 30 June 2019. We considered all maternal and birth cohort studies conducted in the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE)). We categorized cohort studies on the basis of the exposure(s) (anthropometric, environmental, medical, maternal/reproductive, perinatal, or socioeconomic) and outcome(s) (maternal or birth) being measured. Adjusted weighted effect estimates, in the form of relative risks, between maternal obesity and CS and fetal macrosomia were generated using a randomeffects model. Results: Of 3502 citations, 81 published cohort studies were included. One cohort study was in Bahrain, eight in Kuwait, seven in Qatar, six in Oman, 52 in Saudi Arabia, and seven in the UAE. Majority of the exposures studied were maternal/reproductive (65.2%) or medical (39.5%). Birth and maternal outcomes were reported in 82.7% and in 74.1% of the cohort studies, respectively. In Saudi Arabia, babies born to obese women were at a higher risk of macrosomia (adjusted relative risk (aRR), 1.15; 95% confidence interval (CI), 1.10-1.20; I 2 = 50%) or cesarean section (aRR, 1.21; 95% CI, 1.15-1.26; I 2 = 62.0%). Several cohort studies were only descriptive without reporting the magnitude of the effect estimate between the assessed exposures and outcomes. Conclusions: Cohort studies in the GCC have predominantly focused on reproductive and medical exposures. Obese pregnant women are at an increased risk of undergoing CS delivery or macrosomic births. Longer-term studies that explore a wider range of environmental and biological exposures and outcomes relevant to the GCC region are needed. Systematic review registration: PROSPERO CRD42017068910

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Demographic profile and pregnancy outcomes of adolescents and older mothers in Saudi Arabia: analysis from Riyadh Mother (RAHMA) and Baby cohort study

Cited by 29 publications

References 40 publications

Changing trends of adverse pregnancy outcomes with maternal age in primipara with singleton birth: A join point analysis of a multicenter historical cohort study in China in 2011‐2012

Changing trends of adverse pregnancy outcomes with maternal age in primipara with singleton birth: A join point analysis of a multicenter historical cohort study in China in 2011‐2012

Changing trends of birth weight with maternal age: a cross-sectional study in Xi'an city of Northwestern China

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

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