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Purpose: To evaluate maternal-fetal outcomes in women of advanced maternal age (AMA; >35 years old) and women of physiological maternal age as controls ( C; <35 years old). Methods: Single-center, retrospective case-control analysis, from January 1 to December 31, 2013. For each group, we evaluated obstetric history, number of twin pregnancies, delivery mode, incidence of obstetric diseases and neonatal outcomes (5-min Apgar score, neonatal weight, meconium stained fluid rate, admission to the neonatal intensive care unit rate, and incidence of congenital malformations). Data are presented as n (%) and analyzed with χ test and Fisher exact test (when required). A p value < 0.05 was considered statistically significant. Moreover, we calculated the odds ratio (OR), with confidence interval (CI) at 95 %. Results: We enrolled 1,347 pregnant women, 210 (15.6 %) in AMA and 1,137 (84.4 %) C. AMA patients showed a higher rate of previous (anamnestic) spontaneous abortion (SA; p = 0.001; OR = 2.10) and previous (anamnestic) voluntary pregnancy termination ( p = 0.022; OR = 1.59), iterative cesarean section ( p = 0.026; OR = 2.33), SA ( p = 0.001; OR = 12.82), preterm delivery ( p = 0.001; OR = 69.84), congenital malformations ( p = 0.036; OR = 3.94). In C there was a greater number of nulliparous ( p = 0.009; OR = 0.52) and vaginal deliveries ( p = 0.025; OR = 0.41). There were not any statistically significant differences between the two groups for twin pregnancies ( p = 0.862; OR = 0.97), first cesarean section ( p = 0.145; OR = 0.95), other obstetric diseases and neonatal outcomes. Conclusion: AMA could be considered an important risk factor only for SA and PTD and does not influence neonatal outcomes except for congenital malformations. [ABSTRACT FROM AUTHOR]

Objective: To investigate risk factors and pregnancy outcome of patients with placenta previa. Methods: A population-based study comparing all singleton pregnancies of women with and without placenta previa was conducted. Stratified analysis using multiple logistic regression models was performed to control for confounders. Results: During the study period, there were 185,476 deliveries, of which, 0.42% were complicated with placenta previa. Using a multivariable analysis with backward elimination, the following risk factors were independently associated with placenta previa: infertility treatments (OR 1.97; 95% CI 1.45-2.66; P < 0.001), prior cesarean delivery (CD; OR 1.76; 95% CI 1.48-2.09; P < 0.001) and advanced maternal age (OR 1.08; 95% CI 1.07-1.09; P < 0.001). Placenta previa was significantly associated with adverse outcomes such as peripartum hysterectomy (5.3 vs. 0.04%; P < 0.001), previous episode of second trimester bleeding (3.9 vs. 0.05%; P < 0.001), blood transfusion (21.9 vs. 1.2%; P < 0.001), maternal sepsis (0.4 vs. 0.02%; P < 0.001), vasa previa (0.5 vs. 0.1%; P < 0.001), malpresentation (19.8 vs. 5.4%; P < 0.001), postpartum hemorrhage (1.4 vs. 0.5%; P = 0.001) and placenta accreta (3.0 vs. 1.3%; P < 0.001). Placenta previa was significantly associated with adverse perinatal outcomes such as higher rates of perinatal mortality (6.6 vs. 1.3%; P < 0.001), an Apgar score <7 after 1 and 5 min (25.3 vs. 5.9%; P < 0.001, and 7.1 vs. 2.6%, P < 0.001, respectively), congenital malformations (11.5 vs. 5.1%; P < 0.001) and intrauterine growth restriction (3.6 vs. 2.1%; P = 0.003). Using another multivariable logistic regression model, with perinatal mortality as the outcome variable, controlling for confounders, such as preterm birth, maternal age, etc., placenta previa was not found as an independent risk factor for perinatal mortality (weighted OR 1.018; 95% CI 0.74-1.40; P = 0.910). Conclusions: Infertility treatments, prior cesarean section, and advanced maternal age are independent risk factors for placenta previa. An increase in the incidence of these risk factors probably contributes to a rise in the number of pregnancies complicated with placenta previa and its association with adverse maternal and perinatal outcomes. Careful surveillance of these risk factors is recommended with timely delivery in order to reduce the associated complications. [ABSTRACT FROM AUTHOR]