1. Would it be too late? A retrospective case-control analysis to evaluate maternal-fetal outcomes in advanced maternal age.
- Author
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Ciancimino, Leonarda, Laganà, Antonio, Chiofalo, Benito, Granese, Roberta, Grasso, Roberta, and Triolo, Onofrio
- Subjects
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AGE factors in human reproduction , *MATERNAL age , *CHILDBIRTH , *CHILDBIRTH in middle age , *PARENTAL age , *PREGNANCY ,PREGNANCY complication risk factors - Abstract
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]
- Published
- 2014
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