Postponing parenthood to advanced age

Abstract

The aim of the Postponing Parenthood project was to investigate several aspects of the delaying of childbearing phenomenon in Sweden and Norway, such as medical risks and parental experiences. Data were retrieved from the Swedish and Norwegian Medical Birth Registers and three different cohorts: the Swedish Young Adult Panel Study, the Norwegian Mother and Child Cohort, and the Swedish Women's Experiences of Childbirth cohort. Postponing childbirth to age 35 years and later increased the risk of rare but serious pregnancy outcomes, such as stillbirth and very preterm birth. Older first-time parents were slightly more anxious during pregnancy, and childbirth overall was experienced as more difficult, compared with younger age groups. First-time mothers' satisfaction with life decreased from about age 28 years, both when measured during pregnancy and early parenthood. Delaying parenthood to mid-30 or later was more related to lifestyle than socioeconomic factors, suggesting that much could be done in terms of informing young persons about the limitations of fertility and assisted reproductive techniques, and the risks associated with advanced parental age.

Keywords: Advanced maternal age; advanced paternal age; delayed childbearing; postponing parenthood.

Figure 1.

Mean age of first-time mothers and fathers in Sweden and Norway 1970–2014. Source: Statistics Sweden and Statistics Norway.

Figure 2.

Reasons for remaining childless in women and men at age 28 and 36 + 40 years. More than one reason possible. Source: Data obtained from Schytt et al., 2014 (7).

Figure 3.

Rates of nulliparous women who have had a miscarriage or been treated for infertility, related to maternal age (n = 41,236 women pregnant with their first child). Source: Figure based on a previously published figure by Nilsen et al., 2012 (8).

Figure 4.

Risk of very preterm birth (22–31 gestational weeks) (PTB) in relation to advanced maternal age in primiparous women in Sweden and Norway. Adjusted odds ratios and 95% confidence intervals (CI). Sweden: n = 644,184; Norway: n = 311,620. Logistic regression analyses adjusted for year of birth, civil status, country of birth, smoking, BMI, chronic hypertension, and diabetes. Source: Figure based on data obtained from Table 1 in Waldenström et al., 2014 (26).

Figure 5.

Risk of stillbirth in relation to advanced maternal age, smoking in early pregnancy, and being overweight or obese. Adjusted odds ratios and 95% confidence intervals (n = 644,184 primiparous women). Logistic regression model including maternal age, smoking, body mass index, and the following potentially confounding factors not shown: year of birth, civil status, country of birth, chronic hypertension, and diabetes. Source: Figure based on data obtained from Table 2 in Waldenström et al., 2014 (26).

Figure 6.

Postnatal assessment of childbirth by maternal age (n = 1184 primiparous women). Source: Figure previously published by Zasloff et al. 2007 (40).

Figure 7.

Depressive symptoms and worries during pregnancy by maternal age (n = 1304 primiparous women). Source: Figure previously published by Zasloff et al. 2007, page 1331 (40).

Figure 8.

Psychological distress (SCL-5 ≥ 1.75) in primiparous women by maternal age, in weeks 17 and 30 of gestation and 6 and 18 months after birth (n = 19,291 primiparous women). Source: Figure previously published by Aasheim et al., 2012 (46).

Figure 9.

Satisfaction with life (SWLS, mean score) in gestational weeks 17 and 30 and at 6 months and 3 years after birth in relation to maternal age (n = 5891 primiparous women). Source: Figure previously published by Aasheim et al., 2014 (48).