Pregnancy Outcome in Women of Advanced Maternal Age: A Cross-Sectional Study in a Turkish Maternity Hospital

Authors

  • Mervan Bekdas Department of Pediatrics, Abant Ä°zzet Baysal University Faculty of Medicine, Bolu
  • Fatih Demircioglu Department of Pediatrics, Abant Ä°zzet Baysal University Faculty of Medicine, Bolu
  • Zeynep Kadı Department of Obstetrics and Gynecology, Dr Lütfi Kırdar Kartal Teaching and Research Hospital, Ä°stanbul
  • Erol Kısmet Department of Pediatrics, Abant Ä°zzet Baysal University Faculty of Medicine, Bolu

DOI:

https://doi.org/10.3889/oamjms.2013.006

Keywords:

advanced maternal age, risk factors, prematurity, neonatal morbidity, neonatal mortality.

Abstract

Background: There is a current trend towards delayed childbearing around the world. This is considered to increase the risk for poor maternal and neonatal outcomes. In this study, we evaluated pregnancy outcomes in women of advanced maternal age in a single maternity hospital in Turkey.

Methods: Medical records of 517 women aged 35 years and older that gave birth between 2009 and 2010 were examined retrospectively. The chi-squared, Mann-Whitney U, and Student t tests were used for statistical analyses.

Results: In total, 462 (89.3%) women aged 39 years or less and 55 (10.6%) women aged 40 years and older were included in the analysis. Cesarean sections, and neonatal mortality were more common in women of advanced maternal age (p = 0.004 and p=0.002, respectively). Neonatal mortality (OR: 0.1; 95% CI 0.02–1; p = 0.032), premature birth (OR: 0.4; 95% CI 0.2–0.8; p = 0.008), and low birth weight (LBW) (OR: 0.2; 95% CI 0.1–0.5; p < 0.001) were significantly higher in women 40 years and older. Respiratory distress syndrome (RDS) developed in 26% of babies with LBWs. All patients of neonatal death were diagnosed with asphyxiation or RDS.

Conclusions: At the Bolu Izzet Baysal Maternity and Children’s Hospital, advanced maternal age was associated with increased adverse fetal and neonatal outcomes.

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References

Schmidt L, Sobotka T, Bentzen JG, Nyboe Andersen A. Demographic and medical consequences of the postponement of parenthood. Human Reprod Update. 2011;18 (1): 29–43.

Cleary-Goldman J, Malone FD, Vidaver J, et al. Impact of maternal age on obstetric outcome. Obstet Gynecol. 2005;10(5):983–990.

MacKay AP, Berg CJ, Duran C, et al. An assessment of pregnancy-related mortality in the United States. Paediatr Perinat Epidemiol. 2005;19:206–214.

Heffner LJ. Advanced Maternal Age-How Old Is Too Old? N Engl J Med. 2004;351(19):1927–29.

Nelson SM, Telfer EE, Anderson RA. The ageing ovary and uterus: new biological insights. Hum Reprod Update. 2013; 19(1): 67–83.

Joseph KS, Allen A, Dodds L, et al. The perinatal effects of delayed childbearing. Obstet Gynecol. 2005;105:1410–8.

Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Türkiye Nüfus ve Sağlık Araştırması, 2008. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü, Başbakanlık Devlet Planlama Teşkilatı Müsteşarlığı ve TÜBİTAK, Ankara, Türkiye. 2009. http://tr.scribd.com/doc/21717405/TNSA-2008-ana-Rapor-tr.

Callaway LK, Lust K, McIntyre HD. Pregnancy outcomes in women of very advanced maternal age. Aust N Z J Obstet Gynaecol. 2005;45:12–16.

Thornberg E, Thiringer K, Odeback A, Milsom I. Birth asphyxia: Incidence, clinical course and outcome in a Swedish population. Acta Paediatr. 1995;84:927–32.

Kenny LC, Lavender T, McNamee R, O'Neill SM, Mills T, Khashan AS. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PLoSOne. 2013;8(2):e56583.

Çetinoğlu EÇ. Canbaz S. Ağlan Z et all. Determination of Prevalance of Advanced Age Pregnancies in Samsun. J Inonu Univ Med Fac. 2006;13(3):167–170.

Jolly M, Sebire N, Haris J et all. The risks associated with pregnancy in women aged 35 years or older, Human Reproduction. 2000;15:2433–2437.

Ananth CV, Vintzileos AM. Ischemic placental disease: epidemiology and risk factors. Eur J Obstet Gynecol Reprod Biol. 2011;159(1):77–82.

Şekeroğlu M, Baksu A, Ince Z et all. Adolescent and old age pregnants obstetric results. The Medical Bulletin of Şişli Etfal Hospital. 2009;43(1):1–7.

Jacobsson B, Ladfors L, Milsom I. Advanced Maternal Age and Adverse Perinatal Outcome. Obstetrics & Gynecology. 2004;104(4):727–733.

Chibber R. Problems of older maternal age and pregnancy outcome. Bahrain med Bull. 2004;26(4):1–9.

Tough SC, Newburn-Cook C, Johnston DW, et al. Delayed childbearing and its impact on population rate changes in lower birth weight, multiple birth, and preterm delivery. Pediatrics. 2002;109:399–403.

Akyol A, Gedikbaşı A, Mağar A et al. Perinatal outcome of pregnancies 40 and overyears. Perinatal J. 2006; 14(1):1–6.

Cnattingius S, Forman MR, Berendes HW et all. Delayed childbearing and risk of adverse perinatal outcome: a population-based study. JAMA. 1992;268:886–90.

Yogev Y, Melamed N, Tenenbaum-Gavish K, et al. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol. 2010;203(558);1–7.

Main DM, Main EK, Moore DH. The relationship between maternal age and uterine dysfunction: a continuous effect throughout reproductive life. Am J Obstet Gynecol. 2000;182(6):1312–20.

Özçelik S. Kale O. Pregnancy at forty and over: Retrospective analysis of ten years period. Perinatal J. 2004;12(4):179–83.

Wang Y, Tanbo T, Abyholm T, Henriksen T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet. 2011; 284:31–37.

Strandjord TP, Emanuel I, Williams MA et all. Respiratory Distress Syndrome and Maternal Birth Weight Effects. Obstetrics & Gynecology. 2000;95(2):174–179.

Russell RB, Gren NS, Steiner CA et all. Cost of Hospitalization for Preterm and LBW Infants in the United States. Pediatrics. 2007;120(1):e1-e9.

Kliegman RM,Stanton BF,St. Geme JWSchor NF,Behrman RE. The fetüs and the neonatal infant. Nelson textbook of pediatrics 19th Ed, 2011:555–56.

Hertz DE. Care of the newborn: a handbook for primary care. Lippincott Williams&Wilkins: Philadelphia, 2005 55–59.

Erdem G, Bakar EE, Yiğit Ş et all. Neurodevelopmental outcome of premature babies treated in Hacettepe University Hospital Neonatal Intensive Care Unit. Çocuk Sağlığı ve Hastalıkları Dergisi. 2006; 49: 185–192.

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Published

2013-12-15

How to Cite

1.
Bekdas M, Demircioglu F, Kadı Z, Kısmet E. Pregnancy Outcome in Women of Advanced Maternal Age: A Cross-Sectional Study in a Turkish Maternity Hospital. Open Access Maced J Med Sci [Internet]. 2013 Dec. 15 [cited 2021 Apr. 12];1(1):27-31. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2013.006

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Section

B - Clinical Sciences