Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age

University of Miami School of Nursing and Health Studies, Coral Gables, FL 33143, USA.
Human Reproduction (Impact Factor: 4.57). 06/2007; 22(5):1264-72. DOI: 10.1093/humrep/del522
Source: PubMed


In the USA, between 1980 and 2004, the proportion of all births increased 2-fold in women aged > or = 30, 3-fold in women aged > or = 35 and nearly 4-fold in women aged > or = 40. The objective of this study was to evaluate the risks of pregnancy complications and adverse outcomes with increasing maternal age using national vital statistics data.
The study population included 8,079,996 live births of singletons of > or = 20 weeks among women aged 30-54 from the 1995-2000 US Birth Cohort Linked Birth/Infant Death Data Set. Outcomes were modelled by maternal age and parity using multinomial logistic regression to calculate adjusted odds ratios (AORs) and 95% confidence intervals.
The risks for most outcomes paralleled increasing maternal age including prolonged and dysfunctional labour, excessive labour bleeding, breech and malpresentation and primary Caesarean delivery. The highest AORs among women aged > or = 45 versus 30-34 by parity (primiparas and multiparas, respectively) were for chronic hypertension (3.70, 4.89), diabetes (2.19, 2.58), primary Caesarean (3.14, 2.85), excessive labour bleeding (1.54, 1.49), pregnancy hypertension (1.55, 2.13) and birth <32 weeks (2.11, 1.77).
Increasing maternal age is associated with significantly elevated risks for pregnancy complications and adverse outcomes, which vary by parity.

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Available from: Barbara Luke, May 16, 2014
    • "With the introduction of reproductive technology, women at advanced fertility ages can sustain a pregnancy, even in postmenopausal states. Therefore, increasing numbers of women of advanced age have entered the obstetric population [1] and in many high-income countries trends toward later childbearing have strongly increased [2]. In the USA, between 1990 and 2004, birth rates increased by 43% in women aged 35–39 years, by 62% in women aged 40–44 years, and by more than 150% in women aged older than 45 years. "
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    • "Stillbirths are complex and multifactorial in nature. Although maternal age is important, they can also be influenced by parity, weight at birth, and duration of gestation (Luke and Brown 2007). Weight and prematurity are recognized as the most important causes of stillbirth (Mohsin et al. 2006). "
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