Risk of morbidity and mortality in preterm infants born to advanced maternal age pregnancies

Year 2022, Volume: 3 Issue: 3, 208 - 213, 30.09.2022

Burak Ceran , Ufuk Çakır , Duran Yıldız , Ali Ulaş Tuğcu , Selcan Sınacı , Cüneyt Tayman

https://doi.org/10.47482/acmr.1134592

Abstract

Background: Little is known about the effect of advanced maternal age on preterm morbidity and mortality. This study aimed to evaluate the possible relationship between maternal age and morbidity and mortality in premature infants born at a gestational age ≤32 weeks.

Methods: Premature infants born at ≤32 weeks of gestation and admitted to the neonatal intensive care unit were divided into three groups by maternal age: <35, 35-39, and ≥40 years. Infant and maternal demographic and clinical characteristics, and preterm morbidity and mortality were compared between the groups.

Results: A total of 827 preterm infants were included. Their distribution by maternal age was as follows: 659 infants in the <35 years group, 120 in the 35-39 years group, and 48 in the ≥40 years age group. Older maternal age was associated with higher gravidity, frequency of assisted reproductive technology use, preeclampsia, gestational diabetes mellitus, and caesarean delivery (P=0.004, P<0.001, P=0.007, P=0.004, and P<0.001, respectively). Respiratory distress syndrome, patent ductus arteriosus, and necrotising enterocolitis were significantly more frequent in preterm infants aged ≥35 years (P=0.014, P=0.029, and P<0.001, respectively).

Conclusions: In addition to the maternal risks associated with pregnancy at older ages, some prematurity morbidities may also increase in frequency. Although this novel study presents important results, further studies are needed to evaluate the relationship between advanced maternal age and preterm morbidity.

Keywords

Maternal age, Preterm infants, Morbidity, Mortality, Aged

Supporting Institution

YOK

Thanks

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References

• 1. Correa-de-Araujo R, Yoon SSS. Clinical Outcomes in High-Risk Pregnancies Due to Advanced Maternal Age. J Womens Health (Larchmt). 2021;30(2):160-167.
• 2. van Roode T, Sharples K, Dickson N, Paul C. Life-Course Relationship between Socioeconomic Circumstances and Timing of First Birth in a Birth Cohort. PLoS One. 2017;12(1):e0170170.
• 3. Lee S, Holden D, Webb R, Ayers S. Pregnancy related risk perception in pregnant women, midwives & doctors: a cross-sectional survey. BMC Pregnancy Childbirth. 2019;19(1):335.
• 4. Abdou CM. Age-Based Reproductive Healthcare Stereotype Threat (HCST) as a Stressor Affecting Prenatal Mental Health in Pregnant Women of Advanced Maternal Age: Measurement, Process, Outcomes, and Interactions with Ethnicity/Race, SES, and Other Social Identities. Curr Epidemiol Rep. 2017;4(2):133-144.
• 5. Dinçgez Çakmak B, Dündar B, Türker ÜA. Perinatal Outcomes of Advanced and Extremely Advanced Maternal Age Pregnancies. Med Bull Haseki. 2019;57(4):366-371.
• 6. van Katwijk C, Peeters LL. Clinical aspects of pregnancy after the age of 35 years: a review of the literature. Hum Reprod Update. 1998;4(2):185-194.
• 7. Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88(1):31-38.
• 8. Fenton TR. A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and a new format. BMC Pediatr. 2003;3:13.
• 9. Cakir U, Tayman C, Buyuktiryaki M, Unsal H, Ozer Bekmez B. Do Calcium and Potassium Levels Influence Ductal Patency in Preterm Infants? Am J Perinatol. 2020;37(11):1123-1129.
• 10. Cakir U, Tayman C, Yucel C. A Novel Diagnostic Marker for the Severity of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants: Interleukin-33. Pediatr Allergy Immunol Pulmonol. 2019;32(1):12-17.
• 11. Chiang MF, Quinn GE, Fielder AR, Ostmo SR, Paul Chan RV, Berrocal A, et al. International Classification of Retinopathy of Prematurity, Third Edition. Ophthalmology. 2021;128(10):e51-e68.
• 12. Volpe JJ. Impaired Neurodevelopmental Outcome After Mild Germinal Matrix-Intraventricular Hemorrhage. Pediatrics. 2015;136(6):1185- 1187.
• 13. Cakir U, Tayman C, Yarci E, Halil H, Buyuktiryaki M, Ulu HO, et al. Novel useful markers for follow-up of necrotizing enterocolitis: endocan and interleukin-33. J Matern Fetal Neonatal Med. 2020;33(14):2333-2341.
• 14. Cakir U, Tayman C, Buyuktiryaki M. An Unknown Risk Factor for Sepsis in Very Low Birth Weight Preterms: ABO Blood Groups (BGaPS Study). Am J Perinatol. 2021;38(7):669-675.
• 15. Canpolat FE, Kadıoğlu Şimşek G, Webbe J, Büyüktiryaki M, Karaçağlar NB, Elbayiyev S, et al. Late Administration of Surfactant May Increase the Risk of Patent Ductus Arteriosus. Front Pediatr. 2020;8:130.
• 16. Kahveci B, Melekoglu R, Evruke IC, Cetin C. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy Childbirth. 2018;18(1):343.
• 17. Leader J, Bajwa A, Lanes A, Hua X, Rennicks White R, Rybak N, et al. The Effect of Very Advanced Maternal Age on Maternal and Neonatal Outcomes: A Systematic Review. J Obstet Gynaecol Can. 2018;40(9):1208-1218.
• 18. Mehari MA, Maeruf H, Robles CC, Woldemariam S, Adhena T, Mulugeta M, et al. Advanced maternal age pregnancy and its adverse obstetrical and perinatal outcomes in Ayder comprehensive specialized hospital, Northern Ethiopia, 2017: a comparative crosssectional study. BMC Pregnancy Childbirth. 2020;20(1):60.
• 19. Asefa U, Ayele WM. Adverse Obstetrical and Perinatal Outcomes Among Advanced Age Pregnant Mothers in Northeast Ethiopia: A Comparative Cross-Sectional Study. Int J Womens Health. 2020;12:1161-1169.
• 20. Londero AP, Rossetti E, Pittini C, Cagnacci A, Driul L. Maternal age and the risk of adverse pregnancy outcomes: a retrospective cohort study. BMC Pregnancy Childbirth. 2019;19(1):261.
• 21. Shan D, Qiu PY, Wu YX, Chen Q, Li AL, Ramadoss S, et al. Pregnancy Outcomes in Women of Advanced Maternal Age: a Retrospective Cohort Study from China. Sci Rep. 2018;8(1):12239.
• 22. Koo YJ, Ryu HM, Yang JH, Lim JH, Lee JE, Kim MY, et al. Pregnancy outcomes according to increasing maternal age. Taiwan J Obstet Gynecol. 2012;51(1):60-65.
• 23. Kim YN, Choi DW, Kim DS, Park EC, Kwon JY. Maternal age and risk of early neonatal mortality: a national cohort study. Sci Rep. 2021;11(1):814.
• 24. Ziadeh SM. Maternal and perinatal outcome in nulliparous women aged 35 and older. Gynecol Obstet Invest. 2002;54(1):6-10.
• 25. Çakir U, Yildiz D, Kahvecioğlu D, Okulu E, Alan S, Erdeve Ö, Heper AO, et al. Placenta, Secret Witness of Infant Morbidities: The Relationship Between Placental Histology and Outcome of the Premature Infant. Turk Patoloji Derg. 2019;35(1):28-35.