Outcome of singleton pregnancy in women ≥45 years old: a retrospective cohort study.

Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University , Tel Aviv , Israel.
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 (Impact Factor: 1.36). 04/2012; 25(11):2190-3. DOI: 10.3109/14767058.2012.684108
Source: PubMed

ABSTRACT Objective: To investigate prematurity rate in women aged ≥45 carrying a singleton pregnancy. Other maternal and neonatal outcomes are also described. Design: Retrospective cohort study. Setting: Women delivering a singleton pregnancy at a single tertiary medical center. Population: The study included all women aged 45 years and over who delivered at 20 weeks gestation or beyond over a 9-year period from May 2000 to May 2009. Methods: Women aged 45 years and over were identified. The study group was compared to a control group of women <40 years with singleton pregnancies conceived by in vitro fertilization (IVF) who delivered during the same time period. Main Outcome Measure(s): Maternal complications during pregnancy and neonatal outcome. Results: During the study period 278 women ≥45 years delivered a singleton pregnancy. The control group included 304 women. The rate of delivery before 37 weeks as well as before 32 weeks were very high in our study group (18.7 vs. 10.9%, p = 0.009 and 5.4 vs. 2.0%, p = 0.04, respectively). In multivariate analysis, older maternal age was not independently related to prematurity. Chronic hypertension (HTN) was found to be a major risk factor associated with prematurity in advanced maternal age. Conclusions: Women ≥45-years-old with a singleton pregnancy carry a higher risk of maternal and perinatal complications. Preterm birth is a significant complication in this age group and is associated with preexisting chronic HTN.

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    ABSTRACT: To describe the obstetric outcome in women at ages ≥ 45. A retrospective cohort study on a large existing database covering all deliveries in the Flanders region, Belgium, was performed, comparing obstetric outcomes at age 25, 35, 40 and 45 or older, for the period 2005-2010. In the period studied, 421 women gave birth at maternal age ≥ 45 vs 3,405, 15,206, 22,586 at ages 40, 35 and 25, respectively. With advancing maternal age, a significant linear increase for low birth weight (< 2,500 g) and preterm delivery (< 37, < 35 weeks and < 29 weeks), maternal hypertension and diabetes, both primary and secondary caesarean section, was noted. Between ages 40 and ≥ 45, both fetal and early neonatal death demonstrated a significant rise from 4.9/1,000 and 1.8/1,000 to 26/1,000 and 9.5/1,000, respectively. With advancing maternal age, a gradual but not statistically significant decline in the proportion of male fetuses was noted, from 51.6% at 25, to 47.2% in the oldest group. Multivariate analysis confirmed advanced maternal age to be a significant factor in low birth weight, preterm delivery, hypertension, diabetes, caesarean section and perinatal mortality. In Flanders, mothers at age 45 and older have a significantly increased risk for low birth weight, preterm delivery, hypertension, diabetes, caesarean section and perinatal mortality.
    Journal of Obstetrics and Gynaecology 04/2014; · 0.60 Impact Factor
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    ABSTRACT: ABSTRACT Aim: Age at delivery has increased in the past decades, leading to a continuous growth of the number of women planning a pregnancy after the age of forty. Because delivering after this age is associated with an increased rate of maternal complications, the objective of this study was to analyze the delivery related issues in women >=40 years of age. Materials and methods: This was a retrospective study conducted in the 1st Clinic of Obstetrics and Gynecology, Cluj- Napoca in a 3-year period. One hundred and forty-two patients >=40 years of age that delivered between 2010 and 2012 were included in the analysis. Results: The frequency of deliveries after the age of 40 was 2.42% of all the deliveries. Eighty percent of nulliparous and 51.72% of multiparous women delivered by cesarean section. A significantly higher percentage of primiparous women delivered by cesarean section compared to secundiparous women (p = 0.0007). Fetal weight was significantly higher in multiparous than in primiparous women in the CS group (p = 0.01). No differences were observed between the Apgar scores according to the delivery mode or parity in the study group. Conclusion: Delivery after 40 years of age is associated with an increased number of obstetrical interventions.
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