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Adelösan ve ileri yaş gebeliklerin maternal, fetal ve neonatal sonuçları: üçüncü basamak referans merkezin on yıllık deneyimi

Year 2021, Volume: 18 Issue: 3, 945 - 950, 25.09.2021
https://doi.org/10.38136/jgon.903783

Abstract

Amaç: Adelösan ve ileri yaş kadınların gebelik özelliklerinin 10 yıl süreyle değerlendirilmesi perinatal ve yenidoğan bakımını etkileyen politikalardaki değişen eğilimlerden ötürü gerekli olabilmektedir. Biz çalışmamızda Orta Anadolu'da Sivas iline bağlı üçüncü basamak bir sevk merkezinde son on yılda adolesan ve ileri yaştaki kadınlarda gebeliklerin maternal, fetal ve neonatal sonuçlarını değerlendirmeyi amaçladık.
Araçlar ve Yöntem: Bu retrospektif çalışmada, 2011-2020 yılları arasında üçüncü basamak sevk merkezimizin kadın hastalıkları biriminde doğum yapan 414 adelösan (10-19 yaş), 428 ileri yaş (≥40 yaş) kadın ve kontrol grubu olan 150 gebenin (20-39 yaş) hastane elektronik kayıtlarından anne ve yenidoğan verilerini topladık.
Bulgular: Yaşamın erken veya geç dönemlerinde çocuk sahibi kadınlardan etkilenen obstetrik ve fetal sonuçlar. Sonuçlarımıza göre ileri yaştaki kadınlarda bir veya daha fazla parite, sezaryen, gestasyonel hipertansiyon ve akut fetal distres oranları kontrollere göre anlamlı olarak daha yüksekti (p <0.05). Ergenlerde bir veya daha fazla parite, sezaryen, gestasyonel diyabet ve> 34 gebelik haftası oranları kontrol grubundakilere göre anlamlı olarak düşüktü (p <0.05).
Sonuç: Bulgularımız, adelösan ve ileri yaş (≥40 yaş) gebeliklerde perinatal ve neonatal istatistiklerinin iyileştiğini desteklemektedir. Bununla birlikte, sağlık hizmeti koşullarında, annelerin ve sağlık çalışanlarının gebelikle ilgili hastalıklar - ölümler hakkında farkındalıklarında ve eğitim - öğretim programlarının uygulanmasında daha fazla ilerlemeye ihtiyaç vardır.

References

  • (1) Pinheiro RL, Areia AL, Mota Pinto A, Donato H. Advanced Maternal Age: Adverse Outcomes of Pregnancy, A Meta-Analysis. Acta Med Port. 2019 Mar 29;32(3):219-226. doi: 10.20344/amp.11057. Epub 2019 Mar 29.
  • (2) Fitzpatrick KE, Tuffnell D, Kurinczuk JJ, Knight M. Pregnancy at very advanced maternal age: a UK population-based cohort study. BJOG. 2017 Jun;124(7):1097-1106. doi: 10.1111/1471-0528.14269. Epub 2016 Sep 1.
  • (3) Marvin-Dowle K, Soltani H. A comparison of neonatal outcomes between adolescent and adult mothers in developed countries: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol X. 2020 Feb 3;6:100109. doi: 10.1016/j.eurox.2020.100109.
  • (4) Indarti J, Al Fattah AN, Dewi Z, Hasani RDK, Mahdi FAN et al.Teenage Pregnancy: Obstetric and Perinatal Outcome in a Tertiary Centre in Indonesia. Obstet Gynecol Int. 2020 Mar 26;2020:2787602. doi: 10.1155/2020/2787602.
  • (5) World Health Organization. The second decade: improving adolescent health and development. WHO, Department of Child and Adolescent Health and Development, Pro-gramme Brochure. Geneva; 1998.
  • (6) https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy. 31 January 2020
  • (7) Althabe F, Moore JL, Gibbons L, Berrueta M, Goudar SS et al. Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network's Maternal Newborn Health Registry study. Reprod Health. 2015;12 Suppl 2(Suppl 2):S8.
  • (8) Mathews TJ, Hamilton BE. Mean age of mother, 1970-2000. Natl Vital Stat Rep. 2002 Dec 11;51(1):1-13.
  • (9) Matthews TJ, Hamilton BE. Delayed childbearing: more women are having their first child later in life. NCHS Data Brief. 2009 Aug;(21):1-8.
  • (10) Bellieni C. The Best Age for Pregnancy and Undue Pressures. J Family Reprod Health. 2016 Sep;10(3):104-107.
  • (11) Türkiye Nüfus ve Sağlık Araştırması, 2008. www.hips.hacettepe.edu.tr/tnsa2008/
  • (12) Arkan DC, Kaplanoğlu M, Kran H, Ozer A, Coşkun A et. al. Adolescent pregnancies and obstetric outcomes in southeast Turkey: data from two regional centers. Clin Exp Obstet Gynecol. 2010;37(2):144-7.
  • (13) Ayhan A, Yüce K, Kisnisci HA. Analysis of 20,291 deliveries in a Turkish institution. Int J Gynaecol Obstet. 1989 Jun;29(2):131-4. doi: 10.1016/0020-7292(89)90842-4.
  • (14) Karabulut A, Ozkan S, Bozkurt AI, Karahan T, Kayan S. Perinatal outcomes and risk factors in adolescent and advanced age pregnancies: comparison with normal reproductive age women. J Obstet Gynaecol. 2013 May;33(4):346-50. doi: 10.3109/01443615.2013.767786
  • (15) Edirne T, Can M, Kolusari A, Yildizhan R, Adali E et al. Trends, characteristics, and outcomes of adolescent pregnancy in eastern Turkey. Int J Gynaecol Obstet. 2010 Aug;110(2):105-8. doi: 10.1016/j.ijgo.2010.03.012.
  • (16) Giri A, Srivastav VR, Suwal A, Tuladhar AS. Advanced maternal age and obstetric outcome. Nepal Med Coll J. 2013 Jun;15(2):87-90.
  • (17) Weng YH, Yang CY, Chiu YW. Risk Assessment of Adverse Birth Outcomes in Relation to Maternal Age. PLoS One. 2014 Dec 10;9(12):e114843. doi: 10.1371/journal.pone.0114843.
  • (18) Kuyumcuoglu U, Guzel AI, Celik Y. Comparison of the risk factors for adverse perinatal outcomes in adolescent age pregnancies and advanced age pregnancies. Ginekol Pol. 2012 Jan;83(1):33-7.
  • (19) Lean SC, Derricott H, Jones RL, Heazell AEP. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS One. 2017 Oct 17;12(10):e0186287. doi: 10.1371/journal.pone.0186287.
  • (20) Salihu HM, Wilson RE, Alio AP, Kirby RS. Advanced maternal age and risk of antepartum and intrapartum stillbirth. J Obstet Gynaecol Res. 2008 Oct;34(5):843-50. doi: 10.1111/j.1447-0756.2008.00855.x.
  • (21) Carolan M. Maternal age ≥45 years and maternal and perinatal outcomes: a review of the evidence. Midwifery. 2013 May;29(5):479-89. doi: 10.1016/j.midw.2012.04.001. Epub 2012 Nov 16.

Maternal, fetal, and neonatal outcomes of pregnancies in adolescents and women of advanced age: ten-year experience of a tertiary referral center

Year 2021, Volume: 18 Issue: 3, 945 - 950, 25.09.2021
https://doi.org/10.38136/jgon.903783

Abstract

Purpose: Regarding changing trends in the policies affecting perinatal and neonatal care, there is a need to assess the stata of pregnancies in adolescents and women of advanced age with the term of ten years. We aimed to evaluate maternal, fetal, and neonatal outcomes of pregnancies in adolescents and women of advanced age during last decade in a tertiary referral center of Sivas province in central Anatolia.
Methods: In this retrospective study, we collected the maternal and neonatal data from the hospital electronic records of 414 adolescents (10-19 years of age), 428 women of advanced age (≥40 years of age), and 150 pregnant controls (20-39 years of age) who delivered in the obstetrics unit of our tertiary referral center between 2011 and 2020.
Results: Obstetric and fetal outcomes affected from women bearing children early or late stages in life. According to our results, rates of one or more parity, cesarean section, gestational hypertension, and acute fetal distress in the women of advanced age were significantly higher than those in the controls (p<0.05). The rates of one or more parity, cesarean section, gestational diabetes and >34 gestational weeks in the adolescents were significantly lower than those in the controls (p<0.05).
Conclusion: Our findings support the improving perinatal and neonatal statistics of pregnancies in adolescents and women of advanced age (≥40 years). Nevertheless, there is a need further advancements in healthcare conditions and awareness of mothers and healthcare workers about pregnancy related morbidities and mortalities and applying educational and training programs.

References

  • (1) Pinheiro RL, Areia AL, Mota Pinto A, Donato H. Advanced Maternal Age: Adverse Outcomes of Pregnancy, A Meta-Analysis. Acta Med Port. 2019 Mar 29;32(3):219-226. doi: 10.20344/amp.11057. Epub 2019 Mar 29.
  • (2) Fitzpatrick KE, Tuffnell D, Kurinczuk JJ, Knight M. Pregnancy at very advanced maternal age: a UK population-based cohort study. BJOG. 2017 Jun;124(7):1097-1106. doi: 10.1111/1471-0528.14269. Epub 2016 Sep 1.
  • (3) Marvin-Dowle K, Soltani H. A comparison of neonatal outcomes between adolescent and adult mothers in developed countries: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol X. 2020 Feb 3;6:100109. doi: 10.1016/j.eurox.2020.100109.
  • (4) Indarti J, Al Fattah AN, Dewi Z, Hasani RDK, Mahdi FAN et al.Teenage Pregnancy: Obstetric and Perinatal Outcome in a Tertiary Centre in Indonesia. Obstet Gynecol Int. 2020 Mar 26;2020:2787602. doi: 10.1155/2020/2787602.
  • (5) World Health Organization. The second decade: improving adolescent health and development. WHO, Department of Child and Adolescent Health and Development, Pro-gramme Brochure. Geneva; 1998.
  • (6) https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy. 31 January 2020
  • (7) Althabe F, Moore JL, Gibbons L, Berrueta M, Goudar SS et al. Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network's Maternal Newborn Health Registry study. Reprod Health. 2015;12 Suppl 2(Suppl 2):S8.
  • (8) Mathews TJ, Hamilton BE. Mean age of mother, 1970-2000. Natl Vital Stat Rep. 2002 Dec 11;51(1):1-13.
  • (9) Matthews TJ, Hamilton BE. Delayed childbearing: more women are having their first child later in life. NCHS Data Brief. 2009 Aug;(21):1-8.
  • (10) Bellieni C. The Best Age for Pregnancy and Undue Pressures. J Family Reprod Health. 2016 Sep;10(3):104-107.
  • (11) Türkiye Nüfus ve Sağlık Araştırması, 2008. www.hips.hacettepe.edu.tr/tnsa2008/
  • (12) Arkan DC, Kaplanoğlu M, Kran H, Ozer A, Coşkun A et. al. Adolescent pregnancies and obstetric outcomes in southeast Turkey: data from two regional centers. Clin Exp Obstet Gynecol. 2010;37(2):144-7.
  • (13) Ayhan A, Yüce K, Kisnisci HA. Analysis of 20,291 deliveries in a Turkish institution. Int J Gynaecol Obstet. 1989 Jun;29(2):131-4. doi: 10.1016/0020-7292(89)90842-4.
  • (14) Karabulut A, Ozkan S, Bozkurt AI, Karahan T, Kayan S. Perinatal outcomes and risk factors in adolescent and advanced age pregnancies: comparison with normal reproductive age women. J Obstet Gynaecol. 2013 May;33(4):346-50. doi: 10.3109/01443615.2013.767786
  • (15) Edirne T, Can M, Kolusari A, Yildizhan R, Adali E et al. Trends, characteristics, and outcomes of adolescent pregnancy in eastern Turkey. Int J Gynaecol Obstet. 2010 Aug;110(2):105-8. doi: 10.1016/j.ijgo.2010.03.012.
  • (16) Giri A, Srivastav VR, Suwal A, Tuladhar AS. Advanced maternal age and obstetric outcome. Nepal Med Coll J. 2013 Jun;15(2):87-90.
  • (17) Weng YH, Yang CY, Chiu YW. Risk Assessment of Adverse Birth Outcomes in Relation to Maternal Age. PLoS One. 2014 Dec 10;9(12):e114843. doi: 10.1371/journal.pone.0114843.
  • (18) Kuyumcuoglu U, Guzel AI, Celik Y. Comparison of the risk factors for adverse perinatal outcomes in adolescent age pregnancies and advanced age pregnancies. Ginekol Pol. 2012 Jan;83(1):33-7.
  • (19) Lean SC, Derricott H, Jones RL, Heazell AEP. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS One. 2017 Oct 17;12(10):e0186287. doi: 10.1371/journal.pone.0186287.
  • (20) Salihu HM, Wilson RE, Alio AP, Kirby RS. Advanced maternal age and risk of antepartum and intrapartum stillbirth. J Obstet Gynaecol Res. 2008 Oct;34(5):843-50. doi: 10.1111/j.1447-0756.2008.00855.x.
  • (21) Carolan M. Maternal age ≥45 years and maternal and perinatal outcomes: a review of the evidence. Midwifery. 2013 May;29(5):479-89. doi: 10.1016/j.midw.2012.04.001. Epub 2012 Nov 16.
There are 21 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Articles
Authors

İrem Küçükyıldız 0000-0002-6604-0713

Dilay Karademir 0000-0002-9813-4255

Nazan Yurtçu 0000-0003-4725-043X

İlkin Seda Can 0000-0002-2029-7281

Tahsin Takcı 0000-0003-1709-1597

Ali Çetin 0000-0002-5767-7894

Publication Date September 25, 2021
Submission Date March 26, 2021
Acceptance Date July 2, 2021
Published in Issue Year 2021 Volume: 18 Issue: 3

Cite

Vancouver Küçükyıldız İ, Karademir D, Yurtçu N, Can İS, Takcı T, Çetin A. Maternal, fetal, and neonatal outcomes of pregnancies in adolescents and women of advanced age: ten-year experience of a tertiary referral center. JGON. 2021;18(3):945-50.