Effect of Maternal Age on Pregnancy Outcome and Cesarean Delivery Rate

Benli, Ali Ramazan; Benli, Neriman Çetin; Usta, Abdullah Taner; Atakul, Tolga; Köroğlu, Mustafa

doi:10.14740/jocmr1904w

Cited by 33 publications

(31 citation statements)

References 18 publications

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“…In this present study, low Apgar score ratios were found higher in the advanced maternal age group. Both this study and the study by Wen et al suggested a correlation between AMA and lower Apgar scoring whereas Benli et al revealed no difference between those above and under the age of 35 years [17,18]. In our study, the proportion of infants with higher Apgar score was higher in group I.…”

Section: Discussionsupporting

confidence: 53%

Attention for fetomaternal and obstetric outcomes of advanced maternal age: a broad range clinical evaluation

Yılmaz¹

2019

Ann Clin Anal Med

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Aim: Pregnancy ≥ 35years may lead to different health problems in neonates. The present study was aimed to investigate the effect of pregnancy ≥ 35 on maternal and infant health. Material and Method: Mothers of the neonates in our neonatal unit were separated into two groups and compared: Group I comprised those between 18 and 35 years old, and Group II comprised those ≥ 35. Results: Out of 1.193 mothers, 22.1% (264) were above the age of 35 years, whereas 77.8 % (929) were under the age of 35 years. However, there was no significant difference between the groups regarding gender, number of previous delivery, gestational week, the rate of neonatal mortality, polyhydramnios, and oligohydramnios. A statistically significant increase in gestational diabetes, the rate of cesarean delivery and the rate of delivery meconium aspiration syndrome and occurrence of preeclampsia were found in the group for those with advanced age than the other group. Discussion: Much attention should be taken in terms of developing preeclampsia and gestational diabetes in advanced maternal age pregnancies. For a closer follow-up of pregnant women ≥ 35, establishing relevant units and referral of mother candidates at this age to experienced centers may help to decrease the higher feto-maternal risks for advanced maternal age population.

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Section: Discussionsupporting

confidence: 53%

Attention for fetomaternal and obstetric outcomes of advanced maternal age: a broad range clinical evaluation

Yılmaz¹

2019

Ann Clin Anal Med

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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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“…). Indeed, maternal age has been shown to independently increase the risk of CS . In a systematic review of 21 studies, AMA was confirmed to be an independent risk factor for CS in both nulliparous women and multiparous women .…”

Section: Discussionmentioning

confidence: 93%

Risk for Cesarean section in women of advanced maternal age under the changed reproductive policy in China: A cohort study in a tertiary hospital in southwestern China

Xie

Lao

et al. 2019

J of Obstet and Gynaecol

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Aim: To describe changed epidemiological features of advanced maternal age (AMA) and to examine the effect of AMA on the risk for Cesarean section (CS) in a Chinese pregnant population. Methods: This retrospective single-center cohort study investigated the changes of epidemiological features of AMA parturients with respect to the revised reproductive policy in China in 43 702 singleton deliveries with live birth at ≥28 weeks managed from January 2005 to December 2016. We also evaluated the pregnancy outcomes in different age groups and risk factors of CS with multivariate analysis. Results: In this 12-year study period, the average maternal age increased from 28.5 to 30.2 years, and the proportion of AMA raised from 6.5% to 17.2%. AMA was significantly associated with increased risk of adverse pregnancy outcomes, and after adjustment for confounding factors, AMA remained a significant independent risk factor for CS. Furthermore, the effect of AMA in nulliparous women on the risk of CS was more significant than in multiparous women, while the history of previous CS (adjusted odds ratio 39.85) and interdelivery interval ≥10 years (adjusted odds ratio 1.52) also increased the risk of CS in multiparous women. Conclusion: AMA increased the risk of a number of adverse pregnancy outcomes, and was independently associated with increased risk for CS. The increasing number of AMA parturients with risk factors is likely to increase CS rate in China in the near future, thus it is imperative to reduce the rate of primary CS as a matter of policy.

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Effect of Maternal Age on Pregnancy Outcome and Cesarean Delivery Rate

Cited by 33 publications

References 18 publications

Attention for fetomaternal and obstetric outcomes of advanced maternal age: a broad range clinical evaluation

Attention for fetomaternal and obstetric outcomes of advanced maternal age: a broad range clinical evaluation

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

Risk for Cesarean section in women of advanced maternal age under the changed reproductive policy in China: A cohort study in a tertiary hospital in southwestern China

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