Is advanced maternal age associated with placental vascular malperfusion? A prospective study from a single tertiary center

Miremerg, Hadas; Frig, Omry; Rona, Shiran; Herman, Hadas Ganer; Mizrachi, Yossi; Schreiber, Letizia; Bar, Jacob; Kovo, Michal; Weiner, Eran

doi:10.1007/s00404-020-05562-x

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…Advanced maternal age is associated with risk factors for MVM and even isolated presence of AMA is reported in a recent study to increase the risk of MVM (adjusted OR 1.18) in term placentas. 22 In our study, 15 percent of the control group and 23 percent of the CHD group were above the age of 35. AMA women with CHD did not have an increased risk of MVM in the absence of maternal risk factors.…”

Section: Discussionmentioning

confidence: 49%

The Association of Fetal Congenital Cardiac Defects and Placental Vascular Malperfusion

et al. 2021

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Objectives Abnormal early angiogenesis appears to impact both placental disorders and fetal congenital heart defects (CHD). We sought to assess the association of placental perfusion defects (PPD) and fetal (CHD). Methods Singleton pregnancies with isolated severe fetal CHD were compared to controls without congenital anomalies or maternal malperfusion (MVM) risk factors. CHD was categorized into group 1: single left ventricle morphology and transposition of the great vessels (TGA) and group 2: single right ventricle and two ventricle morphology. Malperfusion was defined as fetal vascular malperfusion (FVM), MVM, and both FVM and MVM. Results PPD was increased for all CHD (n = 47), CHD with or without risk factors, and CHD groups compared to controls (n = 92). Overall CHD cases and CHD with risk factors had an increased risk of FVM (30% and 80% vs 14%), and MVM (43% and 50% vs 21%), respectively. MVM rates were similar in CHD with and without maternal risk factors. FVM (38% vs 14%) and MVM (44% vs 21%) were increased in Group 1. MVM (42% vs 21%) and both FVM and MVM (16% vs 3%) were increased in Group 2. Conclusions PPD risk is increased in severe isolated fetal CHD. The highest risk is seen in fetal CHD with maternal risk factors.

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Section: Discussionmentioning

confidence: 49%

The Association of Fetal Congenital Cardiac Defects and Placental Vascular Malperfusion

et al. 2021

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“…Based on the inverse association of maternal age with placental transfer rates observed in the present study, we hypothesize that placental changes with increasing maternal age might be related to placental transfer. There are many studies of placental changes with increasing maternal age like vascular malperfusion [ 62 , 63 ] and defects of decidualization and placentation [ 64 ]. The rate of maternal blood flow through the intervillous space and area available for exchange across the villous trophoblast epithelium are important variables for regulation of placenta transfer [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

“…The rate of maternal blood flow through the intervillous space and area available for exchange across the villous trophoblast epithelium are important variables for regulation of placenta transfer [ 65 ]. Advanced maternal age was associated with a higher rate of placental maternal vascular lesions [ 62 , 63 ], which is presumed to negatively affect maternal blood flow in the intervillous space and area available for exchange on villous trophoblast epithelium related to placenta transfer. Pan et al also hypothesized that the difference in placental function by maternal age might be an explanation for the difference in placental transfer rate by maternal age, but the result was in the opposite direction [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Placental Transfer and Composition of Perfluoroalkyl Substances (PFASs): A Korean Birth Panel of Parent-Infant Triads

Kang

Kim

Yoon

et al. 2021

Toxics

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Exposure to perfluoroalkyl substances (PFASs) is of public concern due to their persistent exposure and adverse health effects. Placental transfer of PFASs is an important excretion pathway of these chemicals in pregnant women and exposure route in fetuses. We measured PFAS concentrations in maternal, paternal, and umbilical cord serum collected from 62 pregnant Korean women and matched biological fathers of the fetuses. Placental transfer rates (cord to maternal serum ratio) of PFASs were also calculated. Demographics and pregnancy-related factors determining the placental transfer rates were identified using linear regression models. Maternal, paternal, and cord serum showed different PFASs compositions. Among the PFASs, perfluorooctane sulfonate (PFOS) showed the highest concentrations in maternal and paternal serum, while perfluorooctanoic acid (PFOA) showed the highest concentration in cord serum. There was a higher proportion of perfluoroalkyl carboxylic acids (PFCAs) with 9–12 carbon chains than those with 13–14 carbon chains in maternal and paternal serum, but this proportion was in the opposite direction in cord serum. PFOA and perfluorohexane sulfonate (PFHxS) had higher placental transfer rates (means of 0.32 and 0.36, respectively) than PFOS (mean of 0.12), which is in line with the results of previous studies. Gestational age and birth weight were positively associated with placental transfer rate of PFOA, PFHxS, and PFOS, while pre-pregnant BMI and weight were inversely associated with PFOS. This study showed that placental transfer of PFASs differs by compounds and is associated with pregnancy-related factors. Further studies on novel PFASs are warranted for Korean pregnant women.

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“…Understanding the influencing factors of pregnancy outcome of the women with advanced age can help obstetricians to manage elderly pregnant women well, and is also the key to reduce the occurrence of various complications. While maternal age has been shown to play a crucial role in pregnancy-related complications and adverse obstetric and perinatal outcomes (13)(14)(15)(16)(17)(18)(19), studies examining its effect on pregnancy outcomes in the Chinese population are scarce (20,21).…”

Section: Introductionmentioning

confidence: 99%

The effect of maternal age and duration of labor on perinatal and neonatal outcomes: a retrospective cohort study

Shen¹,

Song²,

Zeng³

et al. 2022

Ann Transl Med

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Background: This study aimed to investigate the effect of maternal age and duration of labor on perinatal and neonatal outcomes. The results of this study are expected to provide a basis to aid maternal and child health care personnel to implement health education for late childbearing women.Methods: This was a retrospective observational study, wherein 9,241 parturients were included from 2016 to 2018. Parturients were divided into three groups based on age: <28 (n=2,911), 28-30 (n=3,631), and >30 (n=2,699) years. According to the total duration of labor, those who did not undergo cesarean section (CS) were subgrouped into <420 minutes (n=4,065) and ≥420 minutes (n=4,094) groups. A multivariate logistic regression model was used to investigate associations between age/total duration of labor group factors to different postpartum outcomes, including a switch to emergency CS, puerperal morbidity, abnormal fetal heart rate, and meconium-stained amniotic fluid (MSAF). Results:The rates of postpartum outcomes significantly differed in maternal age groups, including switch to emergency CS (9.07% vs. 13.03% vs. 11.23%; P<0.001), puerperal morbidity (6.32% vs. 6.46% vs. 5.00%; P=0.035), and abnormal fetal heart rate (25.34% vs. 28.21% vs. 25.67%; P=0.017). Of the comparisons between labor time groups, it was found that participants with longer labor time were also significantly higher in the use of episiotomy/forceps (46.61% vs. 69.77%; P<0.001), bleeding amount (381.35±108.02 vs. 389.60±146.40 mL; P=0.004), oxytocin use (25.03% vs. 39.56%; P<0.001), puerperal morbidity (1.98% vs. 6.86%; P<0.001), abnormal fetal heart rate (20.07% vs. 25.15%; P<0.001), and MSAF (26.53% vs. 31.91%; P<0.001). Multivariate logistic regression analysis showed that as age increased, the ORs of switching to emergency CS (1.58 and 1.87, both P<0.001) and having abnormal fetal heart rate (1.20 and 1.38; both P<0.01) also increased. Participants with longer labor time groups the ORs of puerperal morbidity (2.33; P<0.001) and MSAF (1.13; P=0.023) also increased.Conclusions: With the adjustment of covariates. Higher maternal age seems associated to the risk of switching to emergency CS and having abnormal fetal heart rate; longer total duration of labor seems associated to the risk of puerperal morbidity and MSAF.

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Is advanced maternal age associated with placental vascular malperfusion? A prospective study from a single tertiary center

Cited by 10 publications

References 29 publications

The Association of Fetal Congenital Cardiac Defects and Placental Vascular Malperfusion

The Association of Fetal Congenital Cardiac Defects and Placental Vascular Malperfusion

Placental Transfer and Composition of Perfluoroalkyl Substances (PFASs): A Korean Birth Panel of Parent-Infant Triads

The effect of maternal age and duration of labor on perinatal and neonatal outcomes: a retrospective cohort study

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