The impact of parity on perinatal outcomes in pregnancies complicated by advanced maternal age

Abstract

Objective:The purpose of this study was to investigate the impact of parity on perinatal outcomes in pregnancies complicated by advanced maternal age. Material and Methods:A total of 11 587 pregnancies were reviewed retrospectively from patient medical records. Singleton pregnancies greater than 24 weeks of gestation were included. The study group consisted of women ≥40 years old at the time of delivery, and the control group consisted of women aged between 20 and 30 years old. Data regarding age, parity, gestational age, mode of delivery, and obstetric and neonatal complications were collected. Firstly, pregnancies ≥40 years and the younger control group were compared altogether with respect to the obstetric and neonatal complications. Secondly, both groups were divided into subgroups according to parity, and a second comparison was made with controls. Results:Mean maternal age in the study and control groups was 43±2.2 and 24±2.8 years, respectively. In women ≥40 years old, all of the investigated obstetric and neonatal complications except postpartum haemorrhage and foetal malformations were higher when compared to younger controls (p<0.05). In the nulliparous ≥40 year old group, the most significant complications were preterm delivery (45.3%), low 5-minute Apgar score (15.2%), and neonatal intensive care unit admission (15.2%). On the other hand, in the multiparous group, preeclampsia (16.6%), abruptio placentae (5.1%), foetal demise (7.2%), and macrosomia (9.6%) were found to be significantly higher when compared to controls. Conclusion:The study suggests that pregnancies of maternal age ≥40 years carry increased risks for both neonatal and obstetric complications, and these risks seem to be effected by parity. (J Turkish-German Gynecol Assoc 2013; 14: 205-9) Key words: Advanced maternal age, parity, perinatal outcome, neonatal outcome Received: 18 August, 2013 Accepted: 19 September, 2013 Amaç: Bu çalışmanın amacı, paritenin ileri maternal yaş ile komplike olmuş gebeliklerde perinatal sonuçlara olan etkisinin incelenmesidir. Gereç ve IntroductionDelayed childbearing has become increasingly common in the past decades, and this has raised concern for the possible risks for both the mother and the foetus. In numerous previous studies, a maternal age ≥40 years has been reported as a proper cut-off to better identify high-risk women with advanced maternal age (1). The majority of these pregnancies are achieved with assisted reproductive technologies (ART), which also increases the risk of complications. The prevalence of advanced maternal age within all pregnancies has been previously reported to be around 1.5%; however, these numbers may change according to the population studied (2, 3). Advanced maternal age is well known to be

Correlation of cord blood bilirubin and neonatal hyperbilirubinemia in healthy newborns

“…In a study by Başer et al, for advancing age pregnancy (>40 years) the NICU admission rate was almost twice in nullipara (15.2%) as compared to multipara (5.7%), whereas in mothers aged 20-30 years the rate of NICU admission was lower in nullipara (6.9%) as compared to multipara (8.9%). 15 Although, none of the mothers in present study were aged >40 years and as such proportional distribution of multipara to nullipara in present study (54/46; 1.17:1) is similar to that reported in the cited study (1.29:1). Pregnancy induced hypertension is a known risk factor for NICU admission.…”

Advanced maternal age and its association with placenta praevia and placental abruption: a meta-analysis

“…Studies have shown an association between AMA and gestational complications, such as gestational diabetes, gestational hypertension, C-section, preeclampsia, premature rupture of membranes, and chromosomal fetal anomalies 9,10,11,12,13,14 . However, the evidence is inconclusive regarding the association of AMA with placenta praevia (PP) and placental abruption (PA), with some studies indicating a positive association 12,14,15,16 and others showing no statistically significant association 13,17,18,19,20,21,22,23,24,25 .…”

Rates of Deliveries with Vacuum Extraction and the Relationship Between Maternal Age, Parity and Neonatal APGAR Scores

“…Sekeroglu et al (17) and Baser et al (18) reported that higher maternal age is associated with decreased APGAR scores and poor neonatal outcomes. In this study maternal age was negatively correlated with 1 th minute-APGAR scores but there was no significant correlation with 5 th minute APGAR scores, and material age.…”