Article

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: 1.37). 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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    • "Ma már számos közlemény [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29] [30] [31] [32] [33] [34] [35] [36] [37] [38] [39] [40] [41] [42] [43] [44] [45] [46] [47] [48] [49] [50] foglalkozik az idősebb anyai életkorban vállalt terhességek kimenetelével. Az eredmények szerint az átlagos születési súly alacsonyabb volt az idősebb korcsoportokban (esélyhányados: 1,1). "

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    ABSTRACT: Iatrogenic twinning has become the main side-effect assisted reproduction treatment. We have evaluated the evidence for additional care that assisted-reproduction twins may require compared with spontaneous twins. Misacarriages are increased in women with tubal problems and after specific treatments. Assisted-reproduction twin pregnancies complicated by a vanishing twin after 8 weeks have an increased risk of preterm delivery and of low and very low birthweight compared with singleton assisted-reproduction pregnancies. Monozygotic twin pregnancies occur at a higher rate after assisted reproduction treatment and are associated with a higher risk of perinatal complications. The incidence of placenta praevia and vasa praevia is increased in assisted-reproduction twin pregnancies. Large cohort studies do not indicate a higher rate of fetal congenital malformations in assisted-reproduction twins. Overall, assisted-reproduction twins in healthy women <45 years of age are not associated with a notable increase in antenatal complication rates and thus do not require additional antenatal care compared with spontaneous twins. The risks of maternal and fetal morbidity and mortality associated with assisted-reproduction twins is only increased in women with a pre-existing medical condition such as hypertensive disorders and diabetes and most of these risks can be avoided with single-embryo transfer. RBMOnline
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    ABSTRACT: Abstract Objective: To investigate prematurity rate in women aged ≥45 carrying a twin pregnancy. Other maternal and neonatal outcomes are also described. Design: Retrospective cohort study. Setting: Women delivering a twin pregnancy at a single tertiary medical center. Population: The study included all women aged 45 years and over carrying a twin pregnancy 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, all conceived by in vitro fertilization with ovum donation. The study group was compared to a control group of women <40 years with twin pregnancies conceived by IVF who delivered during the same time period. Main outcome measure(s): Maternal complications during pregnancy and neonatal outcome. Results: During the study period 32 women ≥45 years delivered twins. The control group included 109 women. The rate of delivery before 37 weeks as well as before 32 weeks were very high in our study group (65% versus 40%, p = 0.01 and 15% versus 5.0%, p = 0.05, respectively). The rate of maternal life-threatening complications including blood product transfusion and maternal admission to the intensive care unit were also significantly higher in our study group compared to the control group (18% versus 2%, p = 0.018 and 6.3% versus none, p = 0.05). Conclusions: Women ≥45 years old with twin pregnancy carry a higher risk of maternal and perinatal complications.
    No preview · Article · Dec 2012 · 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
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