Tags

Type your tag names separated by a space and hit enter

Maternal age over 40 years and pregnancy outcome: a hospital-based survey.
J Matern Fetal Neonatal Med. 2019 May; 32(10):1602-1608.JM

Abstract

OBJECTIVE

Increased risk for adverse pregnancy outcomes with advancing maternal age has been described but the strength of association remains debated, particularly in presence of confounding factors such as parity, twin pregnancy and pregnancy from assisted reproductive technologies. The aim of this study was to evaluate pregnancy outcomes in a large cohort of women aged over 40 years. The hypothesis was that advanced maternal age may be an independent risk factor for adverse pregnancy outcome.

STUDY DESIGN

We reviewed the clinical records of 56,211 women who delivered at Sant'Anna University Hospital, Turin, Italy, in the period between 2009 and 2015. Of these, 3798 women aged over 40 years were divided into two age groups (40 - 44 years and ≥45 years). Women of any parity, with singleton or twin pregnancies, or with assisted reproductive technology pregnancies were included. Women aged less than 40 years were considered as controls. Primary outcome measures were maternal and perinatal complications. Comparisons were performed using Chi-square test and Fisher's exact test. Univariate analysis and logistic regression analysis were performed to test the possible independent role of maternal age as a risk factor for adverse pregnancy outcome.

RESULTS

Maternal age was an independent risk factor for gestational diabetes (age 40-44 years: odds ratios (OR) 2.10, 95% CI 1.80-2.45; age ≥45 years: OR 2.83, 95% CI 1.79-4.46) and early-onset preeclampsia (age 40-44 years: OR 2.10, 95% CI 1.63-2.70; age ≥45 years: OR 3.16, 95% CI 1.68-5.94). The risk for placenta praevia was higher in the women aged 40-44 years (OR 1.87, 95% CI 1.36-2.57). Neonatal outcomes were similar among groups, except for the rate of birth weight less than 2500 g, which was higher in women aged 40-44 years (OR 1.27, 95% CI 1.12-1.42). However, older women showed an overall higher incidence of preterm birth.

CONCLUSIONS

Maternal age over 40 years is an independent risk factor for adverse pregnancy outcomes, particularly for the mother. Pregnancies in women over 40 years should be considered at risk and carefully monitored with individualized care protocols.

Authors+Show Affiliations

a Department of Surgical Sciences , University of Turin , Turin , Italy. b Department of Obstetrics and Gynecology 1 , University of Turin , Turin , Italy.a Department of Surgical Sciences , University of Turin , Turin , Italy. b Department of Obstetrics and Gynecology 1 , University of Turin , Turin , Italy.a Department of Surgical Sciences , University of Turin , Turin , Italy.a Department of Surgical Sciences , University of Turin , Turin , Italy. b Department of Obstetrics and Gynecology 1 , University of Turin , Turin , Italy.c Department of Clinical and Biological Sciences , University of Turin , Turin , Italy.d Department of Public Health and Paediatrics , University of Turin , Turin , Italy.a Department of Surgical Sciences , University of Turin , Turin , Italy. b Department of Obstetrics and Gynecology 1 , University of Turin , Turin , Italy.a Department of Surgical Sciences , University of Turin , Turin , Italy. b Department of Obstetrics and Gynecology 1 , University of Turin , Turin , Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29216770

Citation

Marozio, Luca, et al. "Maternal Age Over 40 Years and Pregnancy Outcome: a Hospital-based Survey." The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, vol. 32, no. 10, 2019, pp. 1602-1608.
Marozio L, Picardo E, Filippini C, et al. Maternal age over 40 years and pregnancy outcome: a hospital-based survey. J Matern Fetal Neonatal Med. 2019;32(10):1602-1608.
Marozio, L., Picardo, E., Filippini, C., Mainolfi, E., Berchialla, P., Cavallo, F., Tancredi, A., & Benedetto, C. (2019). Maternal age over 40 years and pregnancy outcome: a hospital-based survey. The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 32(10), 1602-1608. https://doi.org/10.1080/14767058.2017.1410793
Marozio L, et al. Maternal Age Over 40 Years and Pregnancy Outcome: a Hospital-based Survey. J Matern Fetal Neonatal Med. 2019;32(10):1602-1608. PubMed PMID: 29216770.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal age over 40 years and pregnancy outcome: a hospital-based survey. AU - Marozio,Luca, AU - Picardo,Elisa, AU - Filippini,Claudia, AU - Mainolfi,Erika, AU - Berchialla,Paola, AU - Cavallo,Franco, AU - Tancredi,Annalisa, AU - Benedetto,Chiara, Y1 - 2017/12/07/ PY - 2017/12/9/pubmed PY - 2019/5/24/medline PY - 2017/12/9/entrez KW - Advanced maternal age KW - assisted reproductive technologies KW - perinatal outcomes KW - pregnancy outcomes KW - twin pregnancy SP - 1602 EP - 1608 JF - The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians JO - J. Matern. Fetal. Neonatal. Med. VL - 32 IS - 10 N2 - OBJECTIVE: Increased risk for adverse pregnancy outcomes with advancing maternal age has been described but the strength of association remains debated, particularly in presence of confounding factors such as parity, twin pregnancy and pregnancy from assisted reproductive technologies. The aim of this study was to evaluate pregnancy outcomes in a large cohort of women aged over 40 years. The hypothesis was that advanced maternal age may be an independent risk factor for adverse pregnancy outcome. STUDY DESIGN: We reviewed the clinical records of 56,211 women who delivered at Sant'Anna University Hospital, Turin, Italy, in the period between 2009 and 2015. Of these, 3798 women aged over 40 years were divided into two age groups (40 - 44 years and ≥45 years). Women of any parity, with singleton or twin pregnancies, or with assisted reproductive technology pregnancies were included. Women aged less than 40 years were considered as controls. Primary outcome measures were maternal and perinatal complications. Comparisons were performed using Chi-square test and Fisher's exact test. Univariate analysis and logistic regression analysis were performed to test the possible independent role of maternal age as a risk factor for adverse pregnancy outcome. RESULTS: Maternal age was an independent risk factor for gestational diabetes (age 40-44 years: odds ratios (OR) 2.10, 95% CI 1.80-2.45; age ≥45 years: OR 2.83, 95% CI 1.79-4.46) and early-onset preeclampsia (age 40-44 years: OR 2.10, 95% CI 1.63-2.70; age ≥45 years: OR 3.16, 95% CI 1.68-5.94). The risk for placenta praevia was higher in the women aged 40-44 years (OR 1.87, 95% CI 1.36-2.57). Neonatal outcomes were similar among groups, except for the rate of birth weight less than 2500 g, which was higher in women aged 40-44 years (OR 1.27, 95% CI 1.12-1.42). However, older women showed an overall higher incidence of preterm birth. CONCLUSIONS: Maternal age over 40 years is an independent risk factor for adverse pregnancy outcomes, particularly for the mother. Pregnancies in women over 40 years should be considered at risk and carefully monitored with individualized care protocols. SN - 1476-4954 UR - https://www.unboundmedicine.com/medline/citation/29216770/Maternal_age_over_40_years_and_pregnancy_outcome:_a_hospital_based_survey_ L2 - http://www.tandfonline.com/doi/full/10.1080/14767058.2017.1410793 DB - PRIME DP - Unbound Medicine ER -