Evaluation of Pregnancy Outcomes at Advanced Maternal Age

Abstract

Aim: The study aimed to investigate the association between advanced maternal age (AMA) and the risk of adverse maternal, perinatal and neonatal outcomes about parity in singleton pregnancies.

Methods: We retrospectively analysed 950 women who gave birth in the Department of Obstetrics and Perinatology of the University Hospital in Kraków for six months (between 1^st January and 30^th June 2018). The patients were divided into 3 groups according to their age (30-34 years old, 35-39 years old and over 40 years old). Each of these groups was subsequently subdivided into 2 groups depending on parity (primiparae and multiparae). Maternal, perinatal and neonatal outcomes were compared between the groups and the subgroups.

Results: Comparison of the three age groups revealed that advanced maternal age might constitute a predisposing factor for preterm birth, caesarean section and large for gestational age (LGA). From these parameters, statistical significance was reached in case of greater risk of LGA (OR = 2.17), caesarean section (OR = 2.03) and elective C-section (OR = 1.84) in women over 40 years old when compared to the patients aged 30-34. Furthermore, AMA increases the risk of postpartum haemorrhage (OR = 6.43). Additionally, there is a negative correlation between maternal age and gestational age at delivery (R = -0.106, p < 0.05).

Conclusions: Advanced maternal age can undoubtedly be associated with several adverse perinatal outcomes. At the same time, the risk of perinatal complications begins to increase after the age of 35 but becomes significant in women aged ≥ 40.

Keywords: advanced maternal age; perinatology; pregnancy complications; pregnancy outcomes.

Figure 1

Correlation between maternal age and gestational age at delivery among the whole study population (p<0.05, r= -0.106) (left); Correlation between maternal age and gestational age at delivery among multiparas (p<0.05, r= -0.107) (right)