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Comparative Study
. 2014 Jan;123(1):104-112.
doi: 10.1097/AOG.0000000000000062.

Adverse pregnancy outcomes related to advanced maternal age compared with smoking and being overweight

Ulla Waldenström  1 , Vigdis Aasheim, Anne Britt Vika Nilsen, Svein Rasmussen, Hans Järnbert Pettersson, Erica Shytt
Affiliations
Comparative Study

Adverse pregnancy outcomes related to advanced maternal age compared with smoking and being overweight

Ulla Waldenström et al. Obstet Gynecol. 2014 Jan.

Erratum in

  • Obstet Gynecol. 2014 Mar;123(3):669. Shytt, Erica [corrected to Schytt, Erica]

Abstract

Objective: To investigate the association between advanced maternal age and adverse pregnancy outcomes and to compare the risks related to advanced maternal age with those related to smoking and being overweight or obese.

Methods: A population-based register study including all nulliparous women aged 25 years and older with singleton pregnancies at 22 weeks of gestation or greater who gave birth in Sweden and Norway from 1990 to 2010; 955,804 women were analyzed. In each national sample, adjusted odds ratios (ORs) of very preterm birth, moderately preterm birth, small for gestational age, low Apgar score, fetal death, and neonatal death in women aged 30-34 years (n=319,057), 35-39 years (n=94,789), and 40 years or older (n=15,413) were compared with those of women aged 25-29 years (n=526,545). In the Swedish sample, the number of additional cases of each outcome associated with maternal age 30 years or older, smoking, and overweight or obesity, respectively, was estimated in relation to a low-risk group of nonsmokers of normal weight and aged 25-29 years.

Results: The adjusted OR of all outcomes increased by maternal age in a similar way in Sweden and Norway; and the risk of fetal death was increased even in the 30- to 34-year-old age group (Sweden n=826, adjusted OR 1.24, 95% confidence interval [CI] 1.13-1.37; Norway n=472, adjusted OR 1.26, 95% CI 1.12-1.41). Maternal age 30 years or older was associated with the same number of additional cases of fetal deaths (n=251) as overweight or obesity (n=251).

Conclusion: For the individual woman, the absolute risk for each of the outcomes was small, but for society, it may be significant as a result of the large number of women who give birth after the age of 30 years.

Level of evidence: II.

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References

    1. Newburn-Cook CV, Onyskiw JE. Is older maternal age a risk factor for preterm birth and fetal growth restriction? A systematic review. Health Care Women Int 2005;26:852–75.
    1. Park IY, Kwon JY, Kim YH, Kim M, Shin JC. Maternal age-specific rates of fetal chromosomal abnormalities at 16–20 weeks' gestation in Korean pregnant women >or=35 years of age. Fetal Diagn Ther 2010;27:214–21.
    1. Straube S, Voigt M, Jorch G, Hallier E, Briese V, Borchardt U. Investigation of the association of Apgar score with maternal socio-economic and biological factors: an analysis of German perinatal statistics. Arch Gynecol Obstet 2010;282:135–41.
    1. Flenady V, Koopmans L, Middleton P, Froen JF, Smith GC, Gibbons K, et al.. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011;377:1331–40.
    1. Jacobsson B, Ladfors L, Milsom I. Advanced maternal age and adverse perinatal outcome. Obstet Gynecol 2004;104:727–33.

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