Advanced maternal age and obstetric outcome

Ritu ., Mini .


Background: The objective of this study was to compare the adverse obstetric and perinatal outcome of pregnancies in women with advanced maternal age > 35 years with that of younger women in age group 20-34 years.

Methods: A retrospective comparative study was carried out in department of obstetrics and gynecology at Adesh Medical College over the period of one year from June 2017 to June 2018. The obstetric and perinatal outcome of 100 women with advanced maternal age (study group) was compared with those of 100 younger women aged 20-34 years (control group).

Results: Among antenatal complications, women of advanced maternal age had increased incidence of hypertensive disorder of pregnancy (26.6% versus 4.4%; p = 0.00009) and breech presentation (8.8% versus 1.1%; p = 0.04).  The rate of caesarean delivery was significantly higher in advanced maternal age (28.8% versus 17.7%; p = 0.05). In perinatal outcome, older women had significantly higher incidence of perinatal death (7.7% versus 0%; p = 0.01).

Conclusions: Thus, from this study, it can be concluded that advanced age women had higher incidence of hypertensive disorder of pregnancies and mal presentation, were more likely to deliver by caesarean section and had increased incidence of perinatal death.


Advanced maternal age, Obstetric outcome, Perinatal outcome

Full Text:



G, Berkowitz R. Pregnancy outcome at age 40 and older. Obstet Gynecol. 1996;87:917-22.

Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL. Delayed childbearing and the outcome of pregnancy. N Engl J Med. 1990;322:659-64.

Chloe V, Ruth CF. Pregnancy and advanced maternal age. Progress Obstet Gynecol. 2006;17:113-24.

Naheed F, Tufail A, Kammeruddin K, Madiha S. Obstetrical risks with increased maternal age > 35 years. Pakistan J Surg. 2009;25:240-3.

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;284:31-7.

Matthews TJ, MacDorman MF. Infant mortality statistics from the 2007 period linked birth/infant death data set. Nat’l Vital Stat Rep. 2011;59:1-30.

Osterman MJ, Martin JA, Matthews TJ, Hamilton BE. Expanded data from the new birth certificate 2008. Nat’l Vital Stat Rep. 2011;59:1-28.

Cleary-Goldman J, Malone FD, Vidaver J. Impact of maternal age on obstetric outcome. Obstet Gynecol. 2005;983-90.

Hoque ME. Advanced maternal age and outcomes of pregnancy: a retrospective study from South Africa. Bio Med Res. 2012;23:281-5.

Laopaiboon M, Lumbiganon P, Intarut N, Mori R, Ganchimeg T, Vogel JP, et al. WHO multicountry survey on maternal newborn health research network. advanced maternal age and pregnancy outcomes: a multicountry assessment. BJOG: An Int J Obstet Gynaecol. 2014;121:49-56.

Khalil A, Syngelaki A, Maiz N, Zinevich Y, Nicolaides KH. Maternal age and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol. 2013;42(6):634-43.

Usta IM, Nassar AH. Advanced Maternal age. Part I: obstetric complication. Am J Perinatol. 2008;25:521-34.

Amarin VN, Akasheh HF. Advanced maternal age and pregnancy outcome. East Mediterr Health J. 2001;7:646-51.

Bobrowski RA, Bottoms SF. Underappreciated risks of the elderly multipara. Amer J Obstet Gynecol. 1995;172:1764-70.

Joseph KS, Allen AC, Dods L, Turner L, Scott H, Listor R. The perinatal effects of delayed childbearing. Int J Obstet Gynecol. 2005;105:1410-2.

Duckitt K, Harrington D. Risk factors for preeclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005:330:565.

Fulop T, Larbi A, Douzeicch N. Insulin receptor and ageing. Pathol Biol (Paris). 2003;51:574-80.

Carlon MC, Davey MA, Biro M, Kealy M. Very advanced maternal age and morbidity in Victoria, Australia: a population-based study. BMC Preg Childbirth. 2013;13:80.

Viegas OA, Leong WP, Ahmed S, Ratnam SS. Obstetrical outcome with increasing maternal age. J Bio Soc Sci. 1994;26(2):261-7.

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

Aghamohammadi A, Nooritajer M. Maternal age as a risk factor for pregnancy outcomes: maternal, fetal and neonatal complication. African J Pharm Pharmacol. 2011;5:264-9.

Sahu TM, Agarwal A, Das V. Advanced maternal age and obstetric outcome. J Obstet Gynecol India. 2007;57:320-3.

Bayrampour H, Haeman M. Advanced maternal age and the risk of cesarean birth: a systematic review. Birth Issues Perinatal Care. 2010;37:3.

Roberts CL, Algert CS, Carnegie M, Peat B. Operative delivery during labour: Trends and predictive factors. Paediatr Perinat Epidemiol. 2002;16:115-23.

Lin HC, Sheen TC, Tang CH, Kao S. Association between maternal age and the likelihood of a cesarean section: A population based multivariate logistic analysis. Acta Obstericia et Gynaecologica Scandinavica. 2004;83:1178-83.

Nojomi M, Haghighi L, Bijari B, Rezvani L, Tabatabaee SK. Delayed childbearing and maternal outcomes. Iranian J Reprod Med. 2010;8:80-5.

Verma S. Advanced maternal age and obstetric performance. Apollo Med. 2009;6:258-63.

Odibo A, McDonald R, Nelson D. Advanced maternal age is an independent risk factor for intrauterine growth restriction (IUGR). Am J Obstet Gynecol. 2004;10:157.

Bahtiyar MO, Funai EF, Rosenberg V. Stillbirths at term in women of advanced maternal age in the United States: when could the antenatal testing be initiated? Amer J Perinatol. 2008;25:301-4.

Bateman BT, Simpson LL. Higher rate of stillbirth at the extremes of reproductive age: a large nationwide sample of deliveries in the United States. Am J Obstet Gynecol. 2006;194(3):840-5.

Jacobsson B, Ladfors L, Milson I. Advanced maternal age and adverse perinatal outcome. Obstet Gynecol. 2004;104(4):727-33.