Pregnancies in Women Aged 45 Years and Older – a 10-Year Retrospective Analysis in Berlin

Rendtorff, Rosa; Hinkson, Larry; Kiver, Verena; Dröge, Lisa Antonia; Henrich, Wolfgang

doi:10.1055/s-0043-100105

Cited by 14 publications

(12 citation statements)

References 16 publications

(17 reference statements)

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“…Our analyses showed that the risk of GDM increased by approximately 6% for each year of age. This increase in the risk is in line with findings reported in other publications [ 6 , 31 – 33 ], independently of other risk factors.…”

Section: Discussionsupporting

confidence: 93%

Evaluation of neonatal and maternal morbidity in mothers with gestational diabetes: a population-based study

Domanski

Lange

Ittermann

et al. 2018

BMC Pregnancy Childbirth

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BackgroundGestational diabetes mellitus (GDM) is the most frequent complication during pregnancy. Untreated GDM is a severe threat to maternal and neonatal health. Based on recent evidence, up to 15% of all pregnancies may be affected by GDM. We hypothesized that in a rural birth cohort, higher maternal BMI and adverse socioeconomic conditions would promote GDM, which in turn would lead to adverse effects on pregnancy outcomes.MethodsThe current study is a part of a population-based cohort study examining the health and socioeconomic information from 5801 mothers and their children. The study, titled the Survey of Neonates in Pomerania (SNiP), was based in northeastern Pomerania, Germany (2002–2008).ResultsThe cumulative incidence of GDM was 5.1%. Multiple logistic regression revealed prepregnancy overweight (OR 1.84 (95% CI 1.27–2.68)), prepregnancy obesity (OR 3.67 (2.48–5.44)) and maternal age (OR 1.06 (1.03–1.08)) as risk factors for GDM (p = 0.001). Alcohol use during pregnancy (OR 0.61 (0.41–0.90), a higher monthly income (OR 0.62 (0.46–0.83)), and the highest level of education (OR 0.44 (0.46–0.83)) decreased the risk of GDM.Newborns of GDM mothers had an increased risk of hypoglycaemia (OR 11.71 (7.49–18.30)) or macrosomia (OR 2.43 (1.41–4.18)) and were more often delivered by primary (OR 1.76 (1.21–2.60)) or secondary C-section (OR 2.00 (1.35–2.97)). Moreover, they were born 0.78 weeks (95% CI -1.09 – -0.48 weeks) earlier than infants of mothers without diabetes, resulting in higher percentage of late preterm infants with a gestational age of 32–36 weeks (11.1% vs. 6.96%).ConclusionsAge and BMI before pregnancy were the predominant mediators of the increased risk of GDM, whereas a higher income and educational level were protective. GDM affected relevant perinatal and neonatal outcomes based on its association with an increased risk of delivery by C-section, preterm birth, macrosomia at birth and neonatal hypoglycaemia.

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Section: Discussionsupporting

confidence: 93%

Evaluation of neonatal and maternal morbidity in mothers with gestational diabetes: a population-based study

Domanski

Lange

Ittermann

et al. 2018

BMC Pregnancy Childbirth

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“…In a 10-year retrospective analysis by Rendtorff et al the caesarean section rate was found to be significantly elevated in women aged >45 years old. 23 Moreover, the authors demonstrated that women with advanced age experienced an increased risk of preterm delivery (28% vs. 11%), preeclampsia, gestational diabetes and premature rupture of membranes. Similarly, in a comparison between 35and 20-year-old parous women, Gareen and colleagues reported that the unadjusted risk ratio for caesarean sectionwas 1.40 [95% confidence limit (CL)=1.18-1.65].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of deliveries at a tertiary care hospital in Turkey: results from a retrospective analysis (2012-2016)

Pek

Beyazıt

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Although the choice of a particular method of birth delivery by the pregnant woman is a modern, complex and controversial subject all over the world, the rate of caesarean delivery has risen to nearly 50% in western countries. Apart from medical reasons, several non-medical factors are also involved in this choice, and they comprise the socioeconomic conditions, ethical/legal concerns and psychological and cultural characteristics of the patients and doctors. In this study, we aimed to evaluate the demographic and clinical characteristics of pregnant women who gave birth in a tertiary care hospital between October 2012 and June 2016.Methods: The patients’ charts of pregnant women who presented to the Canakkale Onsekiz Mart University hospital between October 2012 and June 2016 and who gave birth through either vaginal or caesarean delivery were retrospectively analysed. The patients’ age, delivery type, weeks of pregnancy at delivery, number of pregnancies and caesarean indications were recorded.Results: In this study, we retrospectively analysed 2012 pregnant women. The mean age of the pregnant women was 28.9 ±5.4 years. The mean gravida and parity of pregnant women were 1.9±1.0 and 1.5±0.7, respectively. Regardless of the delivery type, the mean pregnancy weeks were found to be 38.6±1.9 weeks. The mean pregnancy weeks of patients undergoing caesarean delivery were 38.4±1.8 weeks. The primary caesarean rates were 52.81%. The most common caesarean delivery indications were foetal distress, cephalopelvic disproportion and presentation anomalies.Conclusions: The steady increase in caesarean delivery rates has become a major cause of concern worldwide. The reasons for this phenomenon are mostly related to advanced age; foetal distress, especially one that is detected in continuous foetal monitoring; intrauterine growth retardation; presentation anomalies and multiple gestation. To avoid unnecessary caesarean births, mothers, especially nulliparous mothers, should be persuaded to undergo vaginal delivery.

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“…O risco dobra quando a pré-eclâmpsia está presente na gestação. 13,19 É consenso na literatura que a idade materna avançada é fator de risco para o parto cesáreo, [5][6]17…”

Section: Introductionunclassified

“…No grupo de gestantes tardias, a única doença em comum foi DMG,11 e em outro foram as infecções do trato urinário 4. Em um estudo, pré-eclâmpsia, síndrome de HELLP e DMG apareceram como fatores de risco para o trabalho de parto prematuro em mulheres em idade avançada 17. Outro, que envolveu diversos países e 37.787 mulheres com idade igual ou maior a 35 anos, encontrou resultados adversos, incluindo morte materna e desfechos maternos graves em pacientes nessa faixa etária 18.…”

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Perfil sociodemográfico e obstétrico de mulheres em idade materna avançada

et al. 2018

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Objetivo: descrever o perfil sociodemográfico e obstétrico de mulheres em idade materna avançada atendidas em 2014 em um hospital universitário do sul do Brasil. Método: pesquisa descritiva, retrospectiva, de abordagem quantitativa, constituída de 223 prontuários de mulheres. Os dados foram coletados por meio de um questionário estruturado no período de setembro de 2015 a janeiro de 2016. Resultados: das mulheres, 68,6% tinham entre 35 e 39 anos, 82,5% brancas, 75,7% casadas, 35,4% tinham ensino médio completo e 51,1% exerciam trabalho remunerado. Quanto ao perfil obstétrico, 91,9% realizaram o pré-natal, 53,4% tiveram parto cesáreo, 75,3% tiveram bebê a termo. Das 75,8% que apresentaram complicações, 14,2% tiveram pré-eclâmpsia e 28,4% diabetes mellitus gestacional. Considerações finais: os dados evidenciam um perfil sociodemográfico de mulheres brancas, com baixo nível de escolaridade e baixa renda. Na perspectiva obstétrica, houve alta porcentagem de complicações associadas à própria idade e às doenças pré-gestacionais.

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Pregnancies in Women Aged 45 Years and Older – a 10-Year Retrospective Analysis in Berlin

Cited by 14 publications

References 16 publications

Evaluation of neonatal and maternal morbidity in mothers with gestational diabetes: a population-based study

Evaluation of neonatal and maternal morbidity in mothers with gestational diabetes: a population-based study

Characteristics of deliveries at a tertiary care hospital in Turkey: results from a retrospective analysis (2012-2016)

Perfil sociodemográfico e obstétrico de mulheres em idade materna avançada

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