A CUT OFF VALUE FOR ADVANCED MATERNAL AGE IN PREDICTING ADVERSE OBSTETRIC AND NEONATAL OUTCOMES IN SPONTANEOUS PREGNANCIES

Yıl 2020, Cilt: 17 Sayı: 3, 446 - 449, 30.09.2020

Canan Unal Atakan Tanacan Erdem Fadıloğlu Nurhayat Halis Murat Cagan M.sinan Beksac

https://doi.org/10.38136/jgon.724384

Öz

Amaç: 40 yaşın üzerindeki spontan gebeliklerde olumsuz obstetrik ve neonatal sonuçları tahmin etmek için anne yaşı için bir eşik değer tanımlamak.
Yöntem: 40 yaş ve üzeri 359 gebelik retrospektif olarak değerlendirildi. Gebeler grup 1 (40-43) ve grup 2 (≥44) olmak üzere iki gruba ayrıldı. Çalışma gruplarının obstetrik ve neonatal sonuçları karşılaştırıldı. Ayrıca maternal yaş açısından olumsuz obstetrik ve neonatal sonuçları tahmin etmek için ROC eğrisi analizi yapıldı.
Bulgular: Obstetrik komplikasyon oranı grup 2'de (% 80.5) grup 1'den (% 36.5) anlamlı olarak daha yüksekti (p <0.001). Preeklampsi oranı da grup 2'de anlamlı olarak daha fazlaydı (p: 0.001). NICU'ya yatış oranları, grup 2'de (% 77.1) grup 1'e (% 28.7) göre istatistiksel olarak anlamlı derecede yüksekti (p <0.001). ROC eğrisi analizi, 41.5 yaşın olumsuz yenidoğan sonuçlarını ve NICU’ya ihtiyacı tahmin etmek için bir eşik değeri olarak bulundu (AUC: 0.607,0.566 sırasıyla).
Sonuç: Doktorlar ileri anne yaşı gebeliklerinin yönetiminde özellikle ≥41,5 yaş grubunda olan annelerde daha dikkatli olmalıdırlar.

Background: To define a cut off value for maternal age to predict adverse obstetric and neonatal outcomes in spontaneous pregnancies ≥40 years of age.
Methods: We retrospectively evaluated 359 pregnant women ≥40 years of age. Patients were enrolled into two groups as Group 1 (40-43) and Group 2 (≥44). We compared the obstetric and neonatal adverse outcomes of the study groups. We also performed ROC curve analysis to predict adverse obstetric and neonatal outcomes in terms of maternal age.
Results: Composite obstetric complication rate was significantly higher in group 2 (80.5%) than in group 1 (36.5%) (p < 0.001). Preeclampsia rate was also significantly more common in group 2 (p: 0.001). Admission to NICU was statistically significantly higher in group 2 (77.1%) compared to group 1 (28.7%) (p < 0.001). ROC curve analysis revealed 41.5 years of age as a cut-off value for predicting adverse neonatal outcomes and NICU admission (AUC: 0.607 and 0.566, respectively).
Conclusion: Physicians should be cautious in the management of advence maternal age (AMA) pregnancies especially in patients with maternal age of ≥41.5 years.

Anahtar Kelimeler

Advanced maternal age, , adverse obstetric outcome, , adverse neonatal outcome, , high risk pregnancy, , pregnancy

Kaynakça

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