Risk of Adverse Pregnancy Outcomes at Advanced Maternal Age

Frederiksen, Line Elmerdahl; Ernst, Andreas; Brix, Nis; Lauridsen, L; Roos, Laura; Ramlau‐Hansen, Cecilia Høst; Ekelund, Charlotte Kvist

doi:10.1097/aog.0000000000002504

Cited by 219 publications

(156 citation statements)

References 22 publications

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“…Age is a well-known risk factor for the development of MAOs during pregnancy [ 28 – 30 ]. Similarly, GDM and gestational hypertension are associated with an increased risk of maternal and neonatal adverse outcomes, especially in case of inadequate glycemic and pressure control [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

C-Reactive Protein Levels at the Midpregnancy Can Predict Gestational Complications

Vecchiè

Bonaventura

Carbone

et al. 2018

BioMed Research International

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Although essential for a successful pregnancy, a growing body of evidence suggests that maternal inflammation, when dysregulated, may represent a risk factor for both maternal and neonatal outcomes. Here, we assessed the accuracy of maternal C-reactive protein (CRP) concentrations at the middle phase of pregnancy in the identification of maternal adverse outcomes (MAO) until delivery. A correlation between CRP and a complicated pregnancy including both maternal and neonatal adverse outcomes has been investigated, too. In this retrospective study, conducted at the Diabetology Unit of IRCCS Ospedale Policlinico San Martino, Genoa (Italy), 380 outpatient pregnant women have been enrolled at the prenatal visit before performing a 75 g oral glucose tolerance test at 24th-26th gestational week for gestational diabetes mellitus (GDM) screening. Demographic, medical, and reproductive history has been obtained by verbal interview. Data about pregnancy and delivery have been retrieved from medical records. The median value of maternal baseline serum CRP was 3.25 μg/mL. Women experiencing MAO were older, more frequently suffering from hypertension, and showed higher CRP concentrations, with a cutoff value >1.86 μg/mL found by a ROC curve analysis to be accurately predictive for MAO. By a logistic regression analysis, serum CRP levels >1.86 μg/mL have been found to predict MAO also considering maternal age, hypertension, and GDM. Maternal CRP levels have been positively associated with overall pregnancy adverse outcomes (maternal and neonatal), too. In conclusion, in pregnant women serum levels of CRP can early recognize subjects at higher risk for maternal and neonatal complications needing a more stringent follow-up.

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Section: Discussionmentioning

confidence: 99%

C-Reactive Protein Levels at the Midpregnancy Can Predict Gestational Complications

Vecchiè

Bonaventura

Carbone

et al. 2018

BioMed Research International

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“…Frederiksen et al ( 11 ) investigated the relationship between advanced maternal age and unfavorable outcomes of pregnancy. Approximately 370,000 single pregnancies were included between 2008 and 2014.…”

Section: Discussionmentioning

confidence: 99%

The relationship between maternal age, body mass index and the rate of preterm birth

Dudenhausen

Kunze

Wittwer-Backofen

et al. 2018

J Turkish German Gynecol Assoc

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Objective:The aim of the present study was to assess the influence of maternal age and maternal body mass index of early pregnancy on the risk of preterm delivery.Material and Methods:The study included 2.1 million liveborn single newborns with documented data at perinatal surveys. Statistical analyses were performed using the SPSS statistics program.Results:The risk of preterm births increased in obese women and in women with advanced age.Conclusion:Strategies should be developed to reduce preconceptional body mass index, and guidelines are required to help advise women who postponed childbearing.

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“…When we assessed risks of induction of labour, operative vaginal delivery and emergency caesarean delivery, we excluded births with an elective caesarean from the denominator as these could not have the outcome of interest. Confounders were chosen a priori based on literature . We adjusted for the mother's country of birth, educational level, smoking status, parity (except in the sensitivity analyses of parity), age, calendar year of birth and BMI.…”

Section: Methodsmentioning

confidence: 99%

Maternal and infant pregnancy outcomes in women with psoriatic arthritis: a Swedish nationwide cohort study

Remaeus

Stephansson

Johansson

et al. 2019

BJOG

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Objective Studies on pregnancy outcomes in psoriatic arthritis (PsA) are scarce and typically of small size. Available studies have reported conflicting results. The aim of this study was to describe maternal and infant pregnancy outcomes among women with PsA compared with women without PsA.Design Nationwide cohort study.Setting Nationwide Swedish registers.Population A total of 41 485 singleton pregnancies in 1997-2014, of which 541 pregnancies were identified with PsA exposure and 40 944 pregnancies were unexposed.Methods By linkage of national health and population register data, we obtained information on individual pregnancies and compared outcomes among pregnancies with PsA and non-PsA pregnancies. Relative risks were estimated by odds ratios (ORs) with 95% CIs using a generalised linear regression model with generalised estimating equations. Adjustments were made for maternal factors and calendar year of birth. Main outcome measures Maternal and infant pregnancy outcomes.Results Pregnancies to women with PsA had increased risks of preterm birth (adjusted OR 1.63; 95% CI 1.17-2.28), elective and emergency caesarean deliveries (adjusted OR 1.47; 95% CI 1.10-1.97 and adjusted OR 1.43; 95% CI 1.08-1.88, respectively) compared with non-PsA pregnancies. No increased risks were observed for pre-eclampsia, stillbirth or other infant outcomes apart from preterm birth. ConclusionThe majority of women with PsA have uneventful pregnancies with respect to adverse outcomes. In the present study, we found increased risks of preterm birth and caesarean delivery compared with non-PsA pregnancies.Keywords Pregnancy outcome, preterm birth, psoriatic arthritis.Tweetable abstract Women with psoriatic arthritis have uneventful pregnancies but are at increased risk of preterm birth and caesarean delivery.

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Risk of Adverse Pregnancy Outcomes at Advanced Maternal Age

Cited by 219 publications

References 22 publications

C-Reactive Protein Levels at the Midpregnancy Can Predict Gestational Complications

C-Reactive Protein Levels at the Midpregnancy Can Predict Gestational Complications

The relationship between maternal age, body mass index and the rate of preterm birth

Maternal and infant pregnancy outcomes in women with psoriatic arthritis: a Swedish nationwide cohort study

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