Maternal and perinatal morbidities associated to advanced age in pregnant women
Main Article Content
Keywords
Perinatal Care, Morbidity, Maternal Health
Abstract
Background: Women in advanced maternal age (older than 35 years of age) are at higher risk of obstetric complications and adverse perinatal outcomes than younger women.
Objective: To know the maternal and perinatal morbidities associated to advanced age in pregnant women.
Material and methods: Analytical cross-sectional study. Women with resolution of pregnancy in the medical unit were included and distributed in two groups: group 1, advanced age, ≥ 35 years, and group 2, < 35 years. Clinical data, maternal and perinatal morbidities of the newborn (NB) were collected from the medical record.
Results: We included 240 patients, 120 per group; a significant association of advanced maternal age with maternal morbidities such as diseases prior to pregnancy was demonstrated (p < 0.0001), including diabetes mellitus during pregnancy (p = 0.002), hypertensive disease of pregnancy (p = 0.0001), pregnancy resolution by cesarean section (p = 0.04), obstetric hemorrhage (p = 0.0002), prenatal control with < 5 consultations (p = 0.008), as well as those with perinatal morbidities of the NB: preterm gestational age (p = 0.001), intrauterine growth retardation (p = 0.01), low weight for gestational age (p = 0.001) and admission of the NB to the neonatal intensive care unit (p = 0.007); with multivariate analysis, an association of advanced maternal age with diabetes mellitus, hypertensive disease of pregnancy and obstetric hemorrhage was observed (R2 = 0.9884; p < 0.0001).
Conclusion: The maternal and perinatal morbidities are associated with advanced age in pregnant women.
References
Waldenstrom U, Cnattingius S, Vixner L, Norman M. Advanced maternal age increases the risk of very preterm birth, irrespective of parity: a population – based register study. BJOG. 2017;124(8):1235-44. doi: 10.1111/1471-0528.14368.
Getaneh T, Asres A, Hiyaru T, Lake S. Adverse perinatal outcomes and its associated factors among adult and advanced maternal age pregnancy in Northwest Ethiopia. Sci Rep. 2021;11(1):14072. doi: 10.1038/s41598-021-93613-x.
Wu Y, Chen Y, Shen M, Guo Y, Wen SW, Lanes A, et al. Adverse maternal and neonatal outcomes among singleton pregnancies in women of very advanced maternal age: a retrospective cohort study. BMC Pregnancy and Childbirth. 2019;19(3): Rev Med Inst Mex Seguro Soc. 2023;61 Supl 2:S83-9 S89 http://revistamedica.imss.gob.mx/1-9. doi: 10.1186/s12884-018-2147-9.
Jackson S, Hong C, Wang ET, Alexander C, Gregory KD, Pisarska MD. Pregnancy outcomes in very advanced maternal age pregnancies: the impact of assisted reproductive technology. Fertil Steril. 2015;103(1):76-80. doi: 10.1016/j. fertnstert.2014.09.037.
Kim YN, Choi DW, Kim DS, Park EC, Kwon JY. Maternal age and risk of early neonatal mortality: a national cohort study. Sci Rep. 2021;11(1):814 doi: 10.1038/s41598-021-80968-4.
Haslinger C, Stoiber B, Capanna F, Schäffer MK, Zimmermann R, Schäffer L. Postponed pregnancies and risks of very advanced maternal age. Swiss Med Wkly. 2016;146:w14330. doi: 10.4414/smw.2016.14330.
Claramonte Nieto M, Meler Barrabes E, Garcia Martínez S, Gutiérrez Prat M, Serra Zantop B. Impact of aging on obstetric outcomes: defining advanced maternal age in Barcelona. BMC Pregnancy Childbirth. 2019;19(1):342. doi: 10.1186/ s12884-019-2415-3.
Ben-David A, Glasser S, Schiff E, Zahav AS, Boyko V, Lerner-Geva L. Pregnancy and Birth Outcomes Among Primiparae at Very Advanced Maternal Age: At What Price? Matern Child Health J. 2016;20(4):833-42. doi: 10.1007/s10995-015-1914-8.
Arya S, Mulla ZD, Plavsic SK. Outcomes of Women Delivering at Very Advanced Maternal Age. J Womens Health (Larchmt). 2018;27(11):1378-84. doi: 10.1089/jwh.2018.7027.
Magnus MC, Wilcox AJ, Morken NH, Weinberg CR, Håberg SE. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ. 2019;364:l869. doi: 10.1136/bmj.l869.
Gómez Real F, Burgess JA, Villani S, Dratva J, Heinrich J, Janson C, et al. Maternal age at delivery, lung function and asthma in offspring: a population-based survey. Eur Respir J. 2018;51 (6):1601611. doi: 10.1183/13993003.01611-2016.
Molina-García L, Hidalgo-Ruiz M, Arredondo-López B, Colomino-Ceprián S, Delgado-Rodríguez M, Martínez-Galiano JM. Maternal Age and Pregnancy, Childbirth and the Puerperium: Obstetric Results. J Clin Med. 2019;8(5):672. doi: 10.3390/ jcm8050672.
Luque Fernández MA. Evolución del riesgo de mortalidad fetal tardía, prematuridad y bajo peso al nacer, asociado a la edad materna avanzada, en España (1996-2005). Gac Sanit. 2008; 22(5):396-403. doi: 10.1157/13126919.
Hidalgo-Lopezosa P, Cobo-Cuenca AI, Carmona-Torres JM, Luque-Carrillo P, Rodríguez-Muñoz PM, Rodríguez-Borrego MA. Factors associated with late fetal mortality. Arch Gynecol Obstet. 2018;297(6):1415-20. doi: 10.1007/s00404-018-4726-4.
Berhan Y, Berhan A. A meta-analysis of selected maternal and fetal factors for perinatal mortality. Ethiop J Health Sci. 2014;24 Suppl(0 Suppl):55-68. doi: 10.4314/ejhs.v24i0.6s.
Leader J, Bajwa A, Lanes A, Hua X, Rennicks White R, Rybak N, et al. The Effect of Very Advanced Maternal Age on Maternal and Neonatal Outcomes: A Systematic Review. J Obstet Gynaecol Can. 2018;40(9):1208-18. doi: 10.1016/j. jogc.2017.10.027.
Carolan M. Maternal age ≥45 years and maternal and perinatal outcomes: a review of the evidence. Midwifery. 2013;29(5):479- 89. doi: 10.1016/j.midw.2012.04.001.
Casteleiro A, Paz-Zulueta M, Parás-Bravo P, Ruiz-Azcona L, Santibañez M. Association between advanced maternal age and maternal and neonatal morbidity: A cross-sectional study on a Spanish population. PLoS One. 2019;14(11):e0225074. doi: 10.1371/journal.pone.0225074.
Lean SC, Derricott H, Jones RL, Heazell AEP. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS One. 2017;12(10):e0186287. doi: 10.1371/journal.pone.0186287.
Pinheiro RL, Areia AL, Mota Pinto A, Donato H. Advanced Maternal Age: Adverse Outcomes of Pregnancy, A Meta-Analysis. Acta Med Port. 2019;32(3):219-26. doi: 10.20344/ amp.11057.
Macías-Villa HLG, Moguel-Hernández A, Iglesias-Leboreiro J, Bernárdez-Zapata I, Braverman-Bronstein A. Edad materna avanzada como factor de riesgo perinatal y del recién nacido. Acta Méd Grupo Ángeles. 2018;16(2):125-32.
González-De la Mora VM. Clasificación de morbilidad y mortalidad materna mediante una escala de disfunción orgánica. Rev Med Inst Mex Seguro Soc. 2020;58(6):686-97. doi: 10.24875/RMIMSS.M20000102.
Díaz-Granda RC, Díaz-Granda L. Anemia gestacional del tercer trimestre: frecuencia y gravedad según la edad materna. Rev Med Inst Mex Seguro Soc. 2020;58(4):428-36. doi: 10.24875/RMIMSS.M20000067.
Bouzaglou A, Aubenas I, Abbou H, Rouanet S, Carbonnel M, Pirtea P, et al. Pregnancy at 40 years Old and Above: Obstetrical, Fetal, and Neonatal Outcomes. Is Age an Independent Risk Factor for Those Complications? Front Med (Lausanne). 2020;7:208. doi: 10.3389/fmed.2020.00208.
Bajana-Quinto MC, Carrasco-Guevara AJ, Zapata-Toapanta AE, Ramírez Santana KE, Cuadro-Terán RE, Ramírez-Santana ME et al. Asociación de la edad materna con las complicaciones gestacionales. Revista Latinoamericana de Hipertensión. 2018;13(2):52-7.
Article Sidebar
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.