Advanced maternal age: maternal and perinatal outcomes

Authors

  • Pooja Sharma Department of Obstetrics and Gynecology, K. J. Somaiya Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20230827

Keywords:

Pregnancy-induced hypertension, Caesarean delivery, Gestational diabetes mellitus, Oligohydramnios

Abstract

Background: Advanced maternal age is significantly associated with adverse obstetrical outcomes like pregnancy-induced hypertension and preterm Delivery. Caesarean delivery is also increased in those mothers. Advanced maternal age pregnancy was also found to be a major risk factor for low birth-weight and perinatal death.

Methods: A hospital based observational study was conducted with 100 patients on attending antenatal-OPD patients at K. J. Somaiya Medical College and Research centre to evaluate the risks involved with advanced maternal age, the obstetric performance with neonatal outcomes of elderly gravidas aged 33 years or older.

Results: The most common maternal complication was gestational diabetes mellitus (16%), pregnancy induced hypertension (13%), pre-eclampsia (11%), malpresentation (8%), oligohydramnios (6%), placenta previa (2%) and post-partum haemorrhage (2%). Caesarean Section in 39% cases and vaginal delivery in 61% cases. (78%) were term deliveries, (22%) were preterm deliveries. (9%) neonates were very low birth weight [<1.5 kg, (34%) neonates were low birth weight (1.5-2.5 kg)] (36%) and (21%) neonates were in the range of 2.6-2.9 kg and ≥3 kg respectively.

Conclusions: Advanced maternal age is significantly associated with adverse obstetrical outcomes like pregnancy-induced hypertension and preterm delivery. Caesarean delivery was increased in those mothers. Advanced maternal age pregnancy was found to be a major risk factor for low birth-weight, perinatal death. Therefore, it is better for health care providers to counsel couples, who seek to have a child in their later ages, about the risks of advanced maternal age pregnancy.

References

Kohler HP, Billari FC, Ortega JA. The emergence of lowest-low fertility in Europe during the 1990s. Popul Develop Rev. 2002;28(4):641-80.

Guedes M, Canavarro MC. Characteristics of primiparous women of advanced age and their partners: a homogenous or heterogenous group? Birth. 2014;41(1):46-55.

Yogev Y, Melamed N, Bardin R, Tenenbaum-Gavish K, Ben-Shitrit G, Ben-Haroush A. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol. 2010;203(6):558.

Chen XK, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol. 2007;36(2):368-73.

Vienne CM, Creveuil C, Dreyfus M. Does young maternal age increase the risk of adverse obstetric, fetal and neonatal outcomes: A cohort study. Eur J Obstet Gynecol Reprod Biol. 2009;147:151-6.

Medicine Net. 2008. Available at: WWW.medterms.com/script/main/criticlekey=33289-35k. Accessed on 18 January 2023.

Schmitz HE, Mcgowan L, Smith CJ. Primiparity after age thirty-five; an analysis of elderly primigravidas. Obstet Gynecol. 1958;11(4):424-30.

Dildy GA, Jackson GM, Fowers GK, Oshiro BT, Varner MW, Clark SL. Very advanced maternal age: pregnancy after age 45. Am J Obstet Gynecol. 1996;175(3 Pt 1):668-74.

Gilbert WM, Nesbitt TS, Danielsen B. Childbearing beyond age 40: pregnancy outcome in 24,032 cases. Obstet Gynecol. 1999;93(1):9-14.

Fretts RC, Schmittdiel J, McLean FH, Usher RH, Goldman MB. Increased maternal age and the risk of fetal death. N Engl J Med. 1995;333(15):953-7.

Mehari MA, Maeruf H, Robles CC, Woldemariam S, Adhena T, Mulugeta M, et al. Advanced maternal age pregnancy and its adverse obstetrical and perinatal outcomes in Ayder comprehensive specialized hospital, Northern Ethiopia, 2017: a comparative cross-sectional study. BMC Pregnancy Childbirth. 2020;20(1):60.

Londero AP, Rossetti E, Pittini C, Cagnacci A, Driul L. Maternal age and the risk of adverse pregnancy outcomes: a retrospective cohort study. BMC Pregnancy Childbirth. 2019;19(1):261.

Paliwal V, Desai R, Jodha BS. Pregnancy Outcome in Elderly Gravida. Indian J Res Gynaecol. 2017;6(3):14-5.

Kalewad PS, Nadkarni T. The perinatal and maternal outcome in pregnancy with advanced maternal age 35 years;35 years. Int J Reprod Contracept Obstet Gynecol. 2016;5:1929-35.

Kahveci B, Melekoglu R, Evruke IC, Cetin C. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy Childbirth. 2018;18(1):343.

Cavazos-Rehg PA, Krauss MJ, Spitznagel EL. Maternal age and risk of labor and delivery complications. Matern Child Health J. 2015;19(6):1202-11.

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. PLoS One. 2013;8(2):e56583.

Schimmel MS, Bromiker R, Hammerman C, Chertman L, Ioscovich A, Granovsky-Grisaru S, et al. The effects of maternal age and parity on maternal and neonatal outcome. Arch Gynecol Obstet. 2015;291(4):793-8.

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(1):31-7.

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Published

2023-03-28

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Original Research Articles