Pregnancy at or beyond age 40 years is associated with an increased risk of fetal death and other adverse outcomes

Hoffman, M. Camille; Jeffers, Sarah; Carter, Jena; Duthely, Lunthita; Cotter, Amanda; González-Quintero, Víctor Hugo

doi:10.1016/j.ajog.2006.10.862

Cited by 104 publications

(92 citation statements)

References 8 publications

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“…This finding was also showed in Hoffman MC [14] study which revealed the rate of PIH in the study group (9.3%) while in the control group (6.9%), this was in accordance with a similar reports from Jahromi BN [15] , Ziadeh S [13] .…”

Section: Discussionsupporting

confidence: 81%

“…The mean gestational age in this study was significantly lower in the study group (37.4 + 2.0) weeks than control group (38.4+ 1.7) weeks which was statistically significant and was approximately resemble the results of study done by Ziadeh S [13] ,who showed in his study the mean gestational age (39.1 + 0.4) weeks in the study group which was significantly lower than control group (39.4 + 0.04) weeks, while Hoffman MC [14] showed in his study the gestational age similar in both groups (39.0 + 3.5) weeks. Mean gravidity in this study was (4.51 + 2.8) which was higher than control group (2.1 + 0.7), this was accordance with a similar report from Hoffman MC [10] study which include mean gravidity in the study group (4.0 + 2.8) and (2.0 + 1.7) in the control group.…”

Section: Discussionsupporting

confidence: 66%

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Pregnancy Outcome in Ladies Aged 40 Years and Above

Mohammed¹

2016

ijSciences

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Many women today are delaying childbearing until the fourth decade of life. The reasons for these delays are multiple and include pursuance of professional careers and delaying of marriage. To study the impact of the maternal age on pregnancy outcome in ladies ≥40 years old. This is a prospective observational case control study conducted at Sulaimania Maternity Teaching Hospital. Time of data collection was from 1 st of December 2013 to the 1 st of June 2014. A total of 300 women were included in the study, 150 cases aged 40 and above as a study group and 150 cases aged 20-29 as a control group, these cases were collected from labour room and operative theatres. All the women included in the study, gave verbal consent and the following informations were obtained by questionnaire forms : Age, parity, gestational age of her pregnancy by LMP and US, any complications during pregnancy like PET, GDM, PIH, PROM, APH, PPH, past medical history, past surgical history and obstetrical history has been also recorded.Duringlabour fetal heart rate monitoring was done with intermittent auscultation by sonic aid only, if meconium detected in the liquor or any fetal HR abnormality then continuous (FHR) monitoring was done until delivery. Mode of delivery by vaginal delivery (normal or operative vaginal delivery) or by caesarean section and its indications were also recorded. After discharge from NCU and hospital, follow up of the babies for one month was done by phone calling of the family of the baby and asking about his/her health and if developed any complications or readmitted again to hospital these information also were recorded.A total of 150 cases aged from 20-29 women were enrolled in the study as a control group and 150 cases aged 40 and more were enrolled as a study group. Mean gestational age of the study group was 37.4 + 2.0 weeks and 38.4 + 1.7 weeks in the control group, the difference was statistically highly significant, P<0.01. Gestational diabetes, preeclampsia, placenta abruption were significantly higher in the study group (26.0%, 45.3%, 8.7%, respectively) compared to control group (11.3%, 16.0%, 1.3% respectively). Caesarean deliveries were high (61.3%) in the study group and it was much higher with history of previous caesarean (48.9%). Incidence of PPH was higher in the study group (30.7%) compared to (16.0%) in control group. APGAR at fifth minute was approximately similar in both groups and statistically was not significant. Admission to neonatal care unit NCU was (50.7%) in study group compared to (16.0%) in control group. Neonatal mortality was high (1.3%) in study group than control group(0.0%).Study conclude Women aged 40 years and above have increased risk of complications during pregnancy and they have a higher risk of operative delivery. Despite of these complications and increased of maternal morbidity in the older women, the overall neonatal outcome did not appear to be affected.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 66%

Pregnancy Outcome in Ladies Aged 40 Years and Above

Mohammed¹

2016

ijSciences

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“…[4][5][6] We could not confirm in our 2008 data the previous findings of an increased risk for very preterm birth. 13,15,16 This might be because multiple pregnancies were excluded from our analysis. However, preterm births in general are not rising in Finland 17 as they are in many other countries.…”

Section: Discussionmentioning

confidence: 99%

Associations of maternal age with maternity care use and birth outcomes in primiparous women: a comparison of results in 1991 and 2008 in Finland

Klemetti

Gissler

Sainio

et al. 2013

BJOG

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Objective To compare birth outcomes and maternity care use in 1991 and 2008 by age among primiparous Finnish women.Design Register-based study.Setting Nationwide Medical Birth Register.Population All primiparous women in 1991 (n = 24 765) and 2008 (n = 23 511).Methods Women aged 35-39 and ≥40 years were compared with women aged 20-34 years in 1991 and 2008, using logistic regression to adjust for women's background.Main outcome measures Maternity care: prenatal visits, hospitalisation during pregnancy, labour induction, delivery mode, long postpartum hospital stay; and birth outcomes: birthweight, preterm birth, Apgar scores, intensive/observation unit, respiratory care, perinatal death.Results In both years, older women's deliveries were more often induced, instrumental, or by caesarean section. In 2008 compared with 1991, hospitalisations were lower and instrumental deliveries and labour induction were higher in older women. A significant decrease in adjusted odds ratios (OR, 95% confidence intervals) between 1991 and 2008 among women aged 35-39 was found for preterm birth (1.47, 1.18-1.84 versus 0.96, 0.86-1.07) and for intensive/observation unit (1.73, 1.47-2.05 versus 1.21, 1.07-1.37) and, among women aged ≥40 years, for intensive/ observation unit (3.14, 2.30-4.29 versus 1.64, 1.31-2.07). The risk for perinatal death (1.66, 0.60-4.60 versus 2.69, 1.07-6.79) was higher in 2008 than in 1991 among women aged ≥40.Conclusions In 2008, older primiparous women still used more maternity care, had more interventions, and poorer birth outcomes than younger women, regardless of care advances. Additional risks declined among women aged 35-39 but not among aged ≥40.Keywords Advanced maternal age, birth outcomes, maternity care use, primiparous women, register study.Please cite this paper as: Klemetti R, Gissler M, Sainio S, Hemminki E. Associations of maternal age with maternity care use and birth outcomes in primiparous women: a comparison of results in 1991and 2008 in Finland. BJOG 2014121:356-362. IntroductionIn 1991 in Finland, older primiparous women had more problems during pregnancy and childbirth, their infant outcomes were worse, and they used more antenatal services than younger primiparous women.1 Since then, the childbearing population has become older and delayed childbearing has become normalised. In Finland, the average age for the first birth was 26.5 years in 1987 and 28.2 years in 2010, and first births to women aged over 35 increased from 5.3% of all first births in 1987 to 10.1% in 2010.2 The proportion of women having their first baby at age 40 or older increased from 12% in 1987 to 20% in 2010.3 Similar trends can be found elsewhere in Europe, the USA and Canada. [4][5][6][7] In Finland, almost all pregnant women (99.7% in 2011) use antenatal care, 2 which is provided in primary health care by public health nurses, midwives and general Maternal medicine practitioners, and by obstetricians and midwives at delivery hospitals during outpatient visits. The average number of prenatal visits was 16 in 2...

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“…Moreover, as already pointed out by some authors [8] in this study, no statistically significant difference was found between infants and children born to older mothers (AMA) and those born to younger mothers (Table 4). In all cases, the high neonatal mortality among low birth weight newborn [12] may explain the low percentage found in this study and considering the children who survived as near miss.…”

Section: Discussionmentioning

confidence: 63%

Pathology of Infants and Children from Mother Older Than 35 Years at CHU of Brazzaville, Congo

ER¹

2016

J Ped Moth Care

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Aims: To determine the rate of admissions of infant and children from the mother older than 35 years, to determine the main pathology sources of hospitalization, to determine the place of birth defects, and to identify their risks factors. Patient and Methods:A cross sectional study comparing infants and children born to the mother (≤ 35 years old = group 2) and those born to the mother older than 35 years (group1) which was conducted from March 2013 to March 2014 in pediatric ward. Results:One hundred and seventeen infants and children born to the older mothers were registered, which is 4% of hospitalization. No predominance of sex was noted (sex ratio = 1). The mean age of infants and children was 11.6 ± 7.9 months old (range, 1 to 30 months).The mean age of older mother was 40 ± 2.6 years (range, 36 to 45years). The main pathology sources of hospitalization were acute gastroenteritis followed by upper respiratory infections. Twenty three(18.8%) had birth defects. The main one was Down syndrome followed by congenital heart defects. The mother's age didn't influence the occurrence of main conditions source of hospitalization in both groups. Lower socio-economic level impacted the occurrence of congenital defects (P < 0.025) and so was the advanced maternal age (AMA) (p ˂ 5%). Primiparity and the first order birth were the predisposing factors for birth defects (p ≤ 0.01). Conclusions:The infants and children of the older mother are less frequently admitted. Under nutrition and birth defects especially down syndrome, are common. There is a close relationship between the lower socio-economic level, the advanced maternal age and the happening of birth defects.

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Pregnancy at or beyond age 40 years is associated with an increased risk of fetal death and other adverse outcomes

Cited by 104 publications

References 8 publications

Pregnancy Outcome in Ladies Aged 40 Years and Above

Pregnancy Outcome in Ladies Aged 40 Years and Above

Associations of maternal age with maternity care use and birth outcomes in primiparous women: a comparison of results in 1991 and 2008 in Finland

Pathology of Infants and Children from Mother Older Than 35 Years at CHU of Brazzaville, Congo

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