Advanced maternal age pregnancy and its adverse obstetrical and perinatal outcomes in Ayder comprehensive specialized hospital, Northern Ethiopia, 2017: a comparative cross-sectional study

Abstract

Background Advanced maternal age generally denotes age after 35 years during the time of delivery. Despite the fact that being pregnant at any reproductive age is not risk-free, older gravidity usually culminates with adverse outcomes both to the mother and fetus or neonate. This study aimed to determine the association of adverse obstetrical and perinatal outcomes with advanced maternal age pregnancy. The study was conducted in Ayder comprehensive specialized hospital, north Ethiopia, from 2015 to 2017. Methods chart review comparative cross-sectional study was employed. Data were retrieved from medical charts of 752 pregnant mothers (376 each for both the study;> 35-year-old and reference group;20-34 year old). Data was collected using a pretested and structured checklist using systematic sampling and data was entered & analyzed using SPSS version 20. Binary and multivariable logistic regression was run to determine the association of independent variables with dependent variables. Results This study revealed that advanced maternal age pregnancy was significantly associated with pregnancy induced hypertension [AOR 4.15, 95% CI (2.272–7.575), p < 0.001], ante partum hemorrhage [AOR 2.54, 95% CI (1.32–4.91), P = 0.005] & cesarean delivery [AOR 2.722, 95% CI (1.777–4.170), p < 0.001]. Furthermore, advanced maternal age pregnancy was also increasingly associated with adverse perinatal outcomes like preterm delivery [AOR 3.622, 95% CI (1.469–8.930), p = 0.005], low birth weight [AOR 3.137, 95% CI (1.324–7.433), p = 0.009], perinatal death [AOR 2.54, 95% CI (1.141–5.635), p = 0.022] and low fifth minute APGAR score [AOR 7.507, 95% CI (3.134–17.98), p < 0.001]. Notwithstanding this, maternal age was not found to be associated with amniotic fluid disturbances, premature rupture of membranes and post-term pregnancy. Conclusions Advanced maternal age is markedly linked with adverse obstetrical and perinatal outcomes. Therefore, it is better for health care providers to counsel couples, who seek to have a child in their later ages, about the risks of advanced maternal age pregnancy. In addition, health care workers need to emphasize on how to improve advanced age mothers’ health through the utilization of contraception to reduce pregnancy in this age group.

Association between maternal gestational weight gain and preterm birth according to body mass index and maternal age in Quzhou, China

“…In this study, we found excess GWG could decrease the incidence of preterm birth in general, but opposite result among women aged 35 years or older. Actually, women with advanced maternal age was considered to have higher risk of preterm birth 14,18 . In these women, excess GWG could lead to pregnancy complications more likely, such as gestational diabetes mellitus and gestational hypertension, which is why the risk of preterm birth is increased 5 .…”

“…Otherwise, pre-pregnancy BMI might play an important role in the relationship between GWG and preterm birth 12,13 . Similarly, the function of maternal age, too, cannot be overlooked 8,14 . But almost all of those studies were carried out in industrialized countries.…”

Profile of pro-inflammatory cytokines in colostrum of nursing mothers at the extremes of reproductive age

“…On the other hand, pregnancies after the age of 35 years are considered late gestation, which has become increasingly frequent due to aspects such as birth control improvement, advances in assisted reproductive technology, late marriages, increased rates of divorce followed by new unions, women with a higher level of education, and advances in health care [5,6]. However, obstetric complications are observed in the pregnancies of advanced maternal age mothers, including antepartum hemorrhage, pregnancy-induced hypertension, diabetes, IUGR, anomalous presentation, macrosomia, dystocia, prolonged gestation, oligohydramnios, polyhydramnios, and preterm labor [5][6][7].…”

Analysis of individual-level and community-level effects on advanced maternal age pregnancy in Nigeria

“…This study examined individual and community effects on advanced maternal age pregnancy, a growing phenomenon with serious implications for maternal, neonatal and child morbidity and mortality [30,[16][17][18][19][20]. The study improved upon previous studies by examining the individual and contextual effects on AMA pregnancy which were largely ignored in most existing hospital-based studies [21-23, 25, 2, 26].…”

“…Two, the proportion of women delaying motherhood for the purpose of achieving education and career enhancement is steadily increasing in the country [15]. Irrespective of the reasons for AMA pregnancy across the world, AMA pregnancy is a safe motherhood issue worthy of further investigation because evidence abounds that AMA pregnancy elevates the risks of maternal, neonatal and child mortality [16][17][18][19][20]. In a number of countries, numerous studies have examined different aspects of AMA pregnancy [21][22][23][24][25][26].…”