Perinatal Outcomes in Advanced Age Pregnancies

Year 2016, Volume: 7 Issue: 2, 157 - 162, 16.06.2016

Ertuğrul Yılmaz

https://doi.org/10.5799/ahinjs.01.2016.02.0589

Abstract

Objective: The aim of this study is to evaluate the impact of advanced maternal age on pregnancy outcomes

Methods: A retrospective analysis of 951 birth
registry records of Zeynep Kamil Hospital, were analyzed between
Janu­ary 2003 and December 2007. Study group was made up of women ≥40
years old and control group was made up of women younger than 40 years.

Results: Mean maternal age was 41.48 years in the
study group and 26.41 years in the control group. Mean gesta­tional age
at the time of delivery is 37.73 weeks in study group and 38.10 weeks in
the control group. There was no statistical difference in terms of
preterm delivery, multiple pregnancy, fetal anomaly, IUGR, superimpose
preeclampsia oligohidramnios, presentation anomaly and placenta previa
rates between the study and control groups. Incidence of preeclampsia
(p=0.041), Chronic hypertension (p=0.001), GDM (p= 0.003),is found to be
higher in study group. Cesar­ean birth rate is higher (p<0.05) and
hospitalization time is longer in study group (p=0.001). 1st minute and
5th minute APGAR scores of the study group (6.99±2, 8.27±2) was lower
than the 1st minute and 5th Minutes APGAR scores of the control group
(7.38±1.6, 8.58±1.7). Neonatal intensive care unit administration rate
is seen also higher in study group (p<0.01).

Conclusion: Advanced maternal age was related to
increased pregnancy complications and poor perinatal outcome.
Preeclampsia, GDM, chronic hypertension is seen more common in advanced
age pregnancies. Neonatal intensive care administration is higher and
APGAR scores are lower; cesarean delivery was performed more common, and
hospitaliza­tion time was longer in advanced age pregnancies. J Clin Exp Invest 2016; 7 (2): 157-162

Keywords

perinatal outcome, advanced age pregnancy, pregnancy outcome

References

• 1. Bobrowski RA, Bottoms SF. Underappreciated risks of the elderly multipara. Am J Obstet Gynecol 1995;172: 1764– 70. 2. Doğum İstatistikleri 2013. Türkiye İstatistik Kurumu haber bülteni 2014;16048 3. Hansen JP. Older maternal age and pregnancy outcome: a review of the literature. Obstet Gynecol Surv 1986;41:726– 42. 4. Van Katwijk C, Peeters LL. Clinical aspects of pregnancy after the age of 35 years: a review of the literature. Hum Reprod Update 1998;4:185-94. 5. Kirz DS, Dorchester W, Freeman RK. Advanced maternalage: The mature gravida. Am J Obstet Gynecol 1985;152:7–12. 6. Bianco A, Stone J, Lynch L, et al. Pregnancy outcome at age 40 and older. Obstet Gynecol 1996;87:917–22. 7. Jacobsson B, Ladfors L, Milsom I. Advenced mater - nal age and adverse perinatal outcome Obstet Gynecol 2004;104:727-33. 8. Usta IM, Nassar AH. Advenced maternal age part 1: Obstet - ric Complications Am J Perinatol 2008;25:521–34. 9. Wang Y, Tanbo T, Abyholm T, Henriksen T. The impact of advanced maternal age and parity on obstetric and perina - tal outcomes in singleton gestations. Arch Gynecol Obstet 2011;284:31-7. 10. Callaway LK, Lust K, McIntyre HD. Pregnancy outcomes in women of very advanced maternal age. Aust N Z J Ob - stet Gynaecol 2005;45:12-6. 11. Taddei S, Virdis A, Mattei P, et al. Ageing and endothelial function in normotensive subjects and patients with essen - tial hypertension. Circulation 1995;91:1981–7. 12. Gilbert WM, Nesbitt TS, Danielsen B. Childbearing beyond age 40: pregnancy outcome in 24,032 cases. Obstet Gyne - col 1999;93:9–14. 13. Dulitzki M, Soriano D, Schiff E, et al. Effect of very ad - vanced maternal age on pregnancy outcome and rate of ce - sarean delivery. Obstet Gynecol 1998;92:935–9. 14. Cleary-Goldman J, Malone FD, Vidaver J, et al. Impact of maternal age on obstetric outcome. Obstet Gynecol 2005;105:983–90. 15. Yasin SY, Beydoun SN. Pregnancy outcome at greater than or equal to 20 weeks’ gestation in women in their 40s. A case-control study. J Reprod Med 1988;33:209–13. 16. Tuck SM, Yudkin PL, Turnbull AC. Pregnancy outcome in elderly primigravidae with and without a history of infertil - ity. Br J Obstet Gynaecol 1988;95:230–7. 17. Lorenza Driul L, Ambrogio P, Londero LA, et al. Preg - nancy outcome and neonatal health by mothers aged 40 years and over. Journal of Medicine and Medical Sciences 2010;1:148-55. 18. Prysak, M, Lorenz, RP, Kisly A. Pregnancy outcome in nulliparous women 35 years and older. Obstet. Gynecol 1995;85:65–70. 19. Barton JR, Bergauer NK, Jacques DL, et al. Does advanced maternal age affect pregnancy outcome in women with mild hypertension remote from term? Am J Obstet Gynecol 1997;176:1236–1243. 20. Dildy GA, Jackson GM, Fowers GK, et al. Very advanced maternal age: pregnancy after age 45. Am J Obstet Gynecol 1996;175:668–74. 21. Lagrew DC Jr, Morgan MA, Nakamoto K, Lagrew N. Ad - vanced maternal age: perinatal outcome when controlling for physician selection. J Perinatol 1996;16:256–60. 22. Tan KT, Tan KH. Pregnancy and delivery in primigravidae aged 35 and over. Singapore Med J 1994;35:495–501. 23. Jolly M, Sebire N, Harris J, et al. The risks associated with pregnancy in women aged 35 years or older. Hum Reprod 2000;15:2433–7. 24. Milner M, Barry-Kinsela C, Unwin A. Harrison RF. The impact of maternal age on pregnancy and its outcome. Int J Gynaecol Obstet. 1992 ;38:281-6. 25. Ezra Y, McPartland P, Farine D. High delivery intervention rates in nulliparous women over age 35. Eur J Obstet Gyne - col Reprod Biol 1995;62:203–7. 26. Lehmann DK, Chism J. Pregnancy outcome in medically complicated and uncomplicated patients aged 40 years or older. Am J Obstet Gynecol 1987;157:738–742. 27. Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL. Delayed childbearing and the outcome of pregnancy. N Engl J Med. 1990 ;322:659-64. 28. Smit Y, Scherjon SA, Treffers PE. Elderly nulliparae in midwifery care in Amsterdam. Midwifery 1997;13:73–7. 29. 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. 30. Delbaere I, Verstraelen H, Goetgeluk S, et al. Pregnancy outcome in primiparae of advanced maternal age. Eur J Ob - stet Gynecol Reprod Biol 2007;135:41–6.