Maternal age and the risk of adverse pregnancy outcomes: a retrospective cohort study.


Journal

BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799

Informations de publication

Date de publication:
23 Jul 2019
Historique:
received: 15 12 2018
accepted: 04 07 2019
entrez: 25 7 2019
pubmed: 25 7 2019
medline: 21 1 2020
Statut: epublish

Résumé

The increased potential for negative pregnancy outcomes in both extremes of reproductive age is a well-debated argument. The aim of this study was to analyze the prevalence and the outcome of pregnancies conceived at extreme maternal ages. This retrospective study considered all single consecutive pregnancies delivered in a tertiary referral center between 2001 and 2014. Patients were categorized into 4 groups according to maternal age at delivery (< 17 years; 18-28 years; 29-39 years; > 40 years). The following outcomes were considered (amongst others): pregnancy-related hypertensive disorders (PRHDs), neonatal resuscitation (NR), neonatal intensive care unit (NICU) admission, periventricular leucomalacia (PVL), and grade 3 and 4 intraventicular hemorrhage (IVH). During the considered period 22,933 single pregnancies gave birth in our unit. We observed 71 women aged < 17 years, and 1552 aged > 40 years. In each year throughout the study period, there was a significant increment in maternal age of 0.041 years (95% CI 0.024-0.058) every new year. Multivariate analysis concluded out that maternal age over 40 years was an independent risk factor for preterm delivery (OR 1.36 95% CI 1.16-1.61, p < 0.05, PRHDs (OR 2.36 95% CI 1.86-3.00, p < 0.05), GDM (OR 1.71 95% CI 1.37-2.12, p < 0.05) cesarean section (OR 1.99 95% CI 1.78-2.23, p < 0.05), abnormal fetal presentation (OR 1.29 95% CI 1.03-1.61, p < 0.05), and fetal PVL (OR 3.32 95% CI 1.17-9.44, p < 0.05). We also observed that maternal age under 17 years or over 40 years was an independent risk factor for grade 3 or 4 neonatal IVH (OR 2.97 95% CI 1.24-7.14, p < 0.05). These findings confirm a negative impact of extreme maternal ages on pregnancy. These results should be carefully taken into account by maternal care providers in order to inform women adequately, supporting them in understanding potential risks associated with their procreation choices, and to improve clinical surveillance.

Sections du résumé

BACKGROUND BACKGROUND
The increased potential for negative pregnancy outcomes in both extremes of reproductive age is a well-debated argument. The aim of this study was to analyze the prevalence and the outcome of pregnancies conceived at extreme maternal ages.
METHODS METHODS
This retrospective study considered all single consecutive pregnancies delivered in a tertiary referral center between 2001 and 2014. Patients were categorized into 4 groups according to maternal age at delivery (< 17 years; 18-28 years; 29-39 years; > 40 years). The following outcomes were considered (amongst others): pregnancy-related hypertensive disorders (PRHDs), neonatal resuscitation (NR), neonatal intensive care unit (NICU) admission, periventricular leucomalacia (PVL), and grade 3 and 4 intraventicular hemorrhage (IVH).
RESULTS RESULTS
During the considered period 22,933 single pregnancies gave birth in our unit. We observed 71 women aged < 17 years, and 1552 aged > 40 years. In each year throughout the study period, there was a significant increment in maternal age of 0.041 years (95% CI 0.024-0.058) every new year. Multivariate analysis concluded out that maternal age over 40 years was an independent risk factor for preterm delivery (OR 1.36 95% CI 1.16-1.61, p < 0.05, PRHDs (OR 2.36 95% CI 1.86-3.00, p < 0.05), GDM (OR 1.71 95% CI 1.37-2.12, p < 0.05) cesarean section (OR 1.99 95% CI 1.78-2.23, p < 0.05), abnormal fetal presentation (OR 1.29 95% CI 1.03-1.61, p < 0.05), and fetal PVL (OR 3.32 95% CI 1.17-9.44, p < 0.05). We also observed that maternal age under 17 years or over 40 years was an independent risk factor for grade 3 or 4 neonatal IVH (OR 2.97 95% CI 1.24-7.14, p < 0.05).
CONCLUSIONS CONCLUSIONS
These findings confirm a negative impact of extreme maternal ages on pregnancy. These results should be carefully taken into account by maternal care providers in order to inform women adequately, supporting them in understanding potential risks associated with their procreation choices, and to improve clinical surveillance.

Identifiants

pubmed: 31337350
doi: 10.1186/s12884-019-2400-x
pii: 10.1186/s12884-019-2400-x
pmc: PMC6651936
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

261

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Auteurs

Ambrogio P Londero (AP)

Clinic of Obstetrics and Gynecology, DAME, University of Udine, Academic Hospital of Udine, Piazza Santa Maria della Misericordia, 15, 33100, Udine, Italy. ambrogio.londero@gmail.com.

Emma Rossetti (E)

Clinic of Obstetrics and Gynecology, DAME, University of Udine, Academic Hospital of Udine, Piazza Santa Maria della Misericordia, 15, 33100, Udine, Italy.

Carla Pittini (C)

Unit of Neonatology, Academic Hospital of Udine, 33100, Udine, Italy.

Angelo Cagnacci (A)

Clinic of Obstetrics and Gynecology, DAME, University of Udine, Academic Hospital of Udine, Piazza Santa Maria della Misericordia, 15, 33100, Udine, Italy.

Lorenza Driul (L)

Clinic of Obstetrics and Gynecology, DAME, University of Udine, Academic Hospital of Udine, Piazza Santa Maria della Misericordia, 15, 33100, Udine, Italy.

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