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

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.