Advanced Maternal Age and Adverse Perinatal Outcomes – One Decade Analysis

Year 2019, Volume: 5 Issue: 1, 11 - 15, 28.04.2019

Seda Keskin

https://doi.org/10.19127/mbsjohs.542026

Abstract

Objective: To appoint the risk of stillbirth and the other adverse maternal and
perinatal outcomes in women of AMA (Advanced maternal age) that traditionally described
as pregnancy in women aged 35 years or older.

Methods: Our study was a retrospective investigation of all women with singleton
pregnancies who gave birth at > 20 weeks’ gestation aged 35 - 39 years old
(early advanced maternal aged group, group I, n=926), aged 40 - 49 years old
(late advanced maternal aged group, group II, n=184) and aged 20 - 35 years old
(control group, group III, n=1110) between January 2008 and January 2018.
Parameters such as age, parity, fetal sex, fetal birth weight, birth pattern
(cesarean and vaginal delivery) were examined. The variables investigated to
determine perinatal outcomes were low birth weight, macrosomic fetus and
stillbirth frequency.

Results: Advanced maternal aged birth ratio to all births was 4.5 %. 83.4% of the
advanced age group were the early advanced maternal aged. The low birth weight
rate was significantly higher in the AMA group (8.6 % - 5.9 %) (p=0.042). At
the same time, the rate of macrosomia was significantly higher in the AMA group
too. (9.5 % - 9.1 %) (p=0.042). The rate of caesarean delivery was
significantly higher in AMA group (63.7 % - 56.4 %). The stillbirth rate was
significantly higher in AMA group (1,6 % - 0,5 %) (p=0.005). In group II; male
gender was lower (47.3 % - 55 %) (p=0.034), stillbirth rate was higher (3.8 % -
1.2 %) (p=0.019), birth weight was lower (3193 - 3287) (p=0.048).

Conclusion: The risk of stillbirth was significantly higher in the late advanced
maternal aged group. Pregnancies over 35 years of age are high-risk pregnancies
necessitating more careful antenatal follow-up in which follow-up of pregnancy
must be done more carefully. National mother friendly health policies must
focus more on AMA pregnancies. More research is needed to find suitable and well-timed
interventions to decrease adverse maternal and also perinatal outcomes.

Keywords

Advanced maternal age, stilbirth, high-risk pregnancies

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