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Microbiology Spectrum Aug 2023The composition of the vaginal microbiota is heavily influenced by pregnancy and may factor into pregnancy complications, including spontaneous preterm birth. However,...
The composition of the vaginal microbiota is heavily influenced by pregnancy and may factor into pregnancy complications, including spontaneous preterm birth. However, results among studies have been inconsistent due, in part, to variation in sample sizes and ethnicity. Thus, an association between the vaginal microbiota and preterm labor continues to be debated. Yet, before assessing associations between the composition of the vaginal microbiota and preterm labor, a robust and in-depth characterization of the vaginal microbiota throughout pregnancy in the specific study population under investigation is required. Here, we report a large longitudinal study ( = 474 women, 1,862 vaginal samples) of a predominantly African-American cohort-a population that experiences a relatively high rate of pregnancy complications-evaluating associations between individual identity, gestational age, and other maternal characteristics with the composition of the vaginal microbiota throughout gestation resulting in term delivery. The principal factors influencing the composition of the vaginal microbiota in pregnancy are individual identity and gestational age at sampling. Other factors are maternal age, parity, obesity, and self-reported use. The general pattern across gestation is for the vaginal microbiota to remain or transition to a state of dominance. This pattern can be modified by maternal parity and obesity. Regardless, network analyses reveal dynamic associations among specific bacterial taxa within the vaginal ecosystem, which shift throughout the course of pregnancy. This study provides a robust foundational understanding of the vaginal microbiota in pregnancy and sets the stage for further investigation of this microbiota in obstetrical disease. There is debate regarding links between the vaginal microbiota and pregnancy complications, especially spontaneous preterm birth. Inconsistencies in results among studies are likely due to differences in sample sizes and cohort ethnicity. Ethnicity is a complicating factor because, although all bacterial taxa commonly inhabiting the vagina are present among all ethnicities, the frequencies of these taxa vary among ethnicities. Therefore, an in-depth characterization of the vaginal microbiota throughout pregnancy in the specific study population under investigation is required prior to evaluating associations between the vaginal microbiota and obstetrical disease. This initial investigation is a large longitudinal study of the vaginal microbiota throughout gestation resulting in a term delivery in a predominantly African-American cohort, a population that experiences disproportionally negative maternal-fetal health outcomes. It establishes the magnitude of associations between maternal characteristics, such as age, parity, body mass index, and self-reported use, on the vaginal microbiota in pregnancy.
Topics: Humans; Pregnancy; Female; Infant, Newborn; Parity; Maternal Age; Pregnant Women; Premature Birth; Gestational Age; Longitudinal Studies; Vagina; Obstetric Labor, Premature; Bacteria; Pregnancy Complications; Obesity; Microbiota
PubMed: 37486223
DOI: 10.1128/spectrum.03429-22 -
Journal of Health Economics Jul 2022This paper analyses the effects of maternal age at birth on children's short and long-term outcomes using Finnish register data. We exploit a school starting age rule...
This paper analyses the effects of maternal age at birth on children's short and long-term outcomes using Finnish register data. We exploit a school starting age rule for identification. Mothers who are born after the school entry cut-off give birth at higher age, but total fertility and earnings are unaffected. Being born after the cut-off reduces gestation and, hence, child birth weight. The effects on birth weight and gestation are rather small, however, suggesting that the long-run impacts may be limited. Accordingly, we find no impacts on longer-term child outcomes, such as educational attainment and adolescent crime rates. Thus, using this source of variation, we find no favorable average effects of maternal age at birth on child outcomes.
Topics: Adolescent; Birth Weight; Child; Educational Status; Female; Humans; Infant, Newborn; Maternal Age; Mothers; Schools
PubMed: 35633595
DOI: 10.1016/j.jhealeco.2022.102637 -
Acta Obstetricia Et Gynecologica... May 2022Several studies have reported on the maternal age-associated risks of congenital anomalies. However, there is a paucity of studies with comprehensive review of... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Several studies have reported on the maternal age-associated risks of congenital anomalies. However, there is a paucity of studies with comprehensive review of anomalies. We aimed to quantify the risk of birth defects in children born to middle-aged mothers compared with that in children born to young or older mothers.
MATERIAL AND METHODS
We classified maternal ages into three groups: young (<20 years old), middle (20-34 years old) and older age (≥35 years old). Observational studies that met our age criteria were eligible for inclusion. The articles searched using the Embase and MEDLINE databases were those published from 1989 to January 21, 2021. The Newcastle-Ottawa scale was used to assess the risk of bias. If heterogeneity exceeded 50%, the random effect method was used; otherwise, the fixed-effect method was used. Prospero registration number: CRD42021235229.
RESULTS
We included 15 cohort, 14 case-control and 36 cross-sectional studies. The pooled unadjusted odds ratio (95% CI) of any congenital anomaly was 1.64 (1.40-1.92) and 1.05 (0.95-1.15) in the older and young age groups, respectively (very low quality of evidence). The pooled unadjusted odds ratio of chromosomal anomaly was 5.64 (5.13-6.20) and 0.69 (0.54-0.88) in the older and young age groups, respectively. The pooled unadjusted odds ratio of non-chromosomal anomaly was 1.09 (1.01-1.17) and 1.10 (1.01-1.21) in the older and young age groups, respectively (very low quality of evidence). The incidence of abdominal wall defects was increased in children of women in the young maternal age group.
CONCLUSIONS
We identified that very low quality evidence suggests that women in the older maternal age group had increased odds of having children with congenital anomalies compared with those in the 20-34 year age group. There was no increase in odds of children with congenital anomalies in women of <20 year age group except for abdominal defects compared with those in the 20-34 year age group. The results stem from very low quality evidence with no adjustment of confounders.
Topics: Adult; Case-Control Studies; Child; Cohort Studies; Congenital Abnormalities; Cross-Sectional Studies; Female; Humans; Maternal Age; Middle Aged; Parturition; Pregnancy; Young Adult
PubMed: 35288928
DOI: 10.1111/aogs.14339 -
In Vivo (Athens, Greece) 2023Due to better career opportunities for women and a shift in sex roles, as well as improved reproductive medicine, the age of women who conceive children is rising. A...
BACKGROUND/AIM
Due to better career opportunities for women and a shift in sex roles, as well as improved reproductive medicine, the age of women who conceive children is rising. A variety of maternal risks and complications that may occur during pregnancy or childbirth in women with advanced maternal age has been examined and reported controversial results. The present study focused on controversial and debatable conclusions regarding the impact of advanced maternal age on maternal and neonatal outcomes.
PATIENTS AND METHODS
Data from 8,523 patients, who gave singleton birth at the Women's University Hospital Cologne between 2014 and 2018, were subdivided into two groups: those with maternal age ≥40 years and those <40, and analyzed.
RESULTS
A significantly higher rate of C-section, more preterm births, more low birth weight, and higher incidence of retained placenta were observed in women older than or equal to 40. There were no significant differences regarding postpartum hemorrhage and fetal position. Younger patients tend to have more birth injuries and use more epidural administration. The evaluation of neonatal outcomes using fetal base-excess, birth pH, and Apgar score showed no significant clinical differences.
CONCLUSION
More antenatal complications could be identified in patients with advanced maternal age. Nonetheless, the neonatal outcomes were comparable and no severe complications in women with advanced maternal age were observed. These findings are due to a well standardized management system for women with risk pregnancies. This encourages better monitoring and care of pregnant women with risk factors.
Topics: Infant, Newborn; Child; Pregnancy; Female; Humans; Adult; Maternal Age; Delivery, Obstetric; Cesarean Section; Premature Birth; Pregnancy Outcome
PubMed: 37369496
DOI: 10.21873/invivo.13256 -
JNCI Cancer Spectrum May 2022Although advanced parental age has been definitively linked to pediatric acute lymphoblastic leukemia, studies of parental age and pediatric solid tumors have not... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although advanced parental age has been definitively linked to pediatric acute lymphoblastic leukemia, studies of parental age and pediatric solid tumors have not reached firm conclusions. This analysis aimed to elucidate the relationship between parental age and pediatric solid tumors through meta-analysis of existing studies based in population registries.
METHODS
We searched Medline (PubMed) and Embase for registry-based studies of parental age and solid tumors through March 2022. We performed random-effects meta-analysis to estimate pooled effects and 95% confidence intervals (CIs). All statistical tests were 2-sided.
RESULTS
A total of 15 studies covering 10 childhood solid tumor types (30 323 cases and 3 499 934 controls) were included in this analysis. A 5-year increase in maternal age was associated with an increased risk of combined central nervous system tumors (odds ratio [OR] = 1.07, 95% CI = 1.04 to 1.10), ependymoma (OR = 1.19, 95% CI = 1.09 to 1.31), astrocytoma (OR = 1.10, 95% CI = 1.05 to 1.15), rhabdomyosarcoma (OR = 1.14, 95% CI = 1.03 to 1.25), and germ cell tumors (OR = 1.06, 95% CI = 1.00 to 1.12). A 5-year increase in paternal age was associated with an increased risk of non-Hodgkin lymphoma (OR = 1.06, 95% CI = 1.00 to 1.12).
CONCLUSIONS
This meta-analysis of registry-based analyses of parental age and childhood cancer supports the association between older maternal age and certain childhood solid cancers. There is also some evidence that paternal age may be associated with certain cancers such as non-Hodgkin lymphoma. However, as maternal and paternal age are highly correlated, disentangling potential independent causal effects of either factor will require large studies with extensive data on potential confounders.
Topics: Child; Humans; Case-Control Studies; Lymphoma, Non-Hodgkin; Parents; Paternal Age; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Male; Female; Maternal Age
PubMed: 35639955
DOI: 10.1093/jncics/pkac040 -
Fertility and Sterility Feb 2020
Topics: Female; Fertilization in Vitro; Humans; Infertility; Maternal Age; Sperm Injections, Intracytoplasmic
PubMed: 32106977
DOI: 10.1016/j.fertnstert.2019.11.004 -
Taiwanese Journal of Obstetrics &... Jan 2021To assess the association between advanced maternal age and adverse perinatal outcomes in single pregnancies.
OBJECTIVES
To assess the association between advanced maternal age and adverse perinatal outcomes in single pregnancies.
MATERIALS AND METHODS
A cohort study was conducted using data from 27,455 singleton births attended at our hospital between 2007 and 2018. Three maternal age groups were established, and perinatal outcomes were compared between-groups (<35 years (n = 19,429; 70.7%), 35-40 years (n = 7189; 26.2%), and >40 years (n = 846; 3.1%). The data were compared using chi-square analysis and the results were adjusted using a logistic regression model. Decision trees were designed to examine the fetal mortality and caesarean section variables. We used the SPSS 23 statistical software program for the statistical analysis.
RESULTS
The mean age of the women was 31.21 years. No differences were found associated with age for neonatal acidosis, an Apgar score <7 at 5 min after birth, threatened preterm labour, preterm rupture of membranes, or high-grade perineal tear. The analyses found statistically significant increases in the rates of hypertensive disorders, diabetes mellitus, induction of labour, and caesarean section, after 35 years of age. The risks of fetal death, neonatal admission, small for gestational age, placenta previa, instrument delivery, maternal ICU admission, and postpartum haemorrhage were greater after 40 years of age.
CONCLUSIONS
The results of our study indicated that women >35 years of age had worse perinatal outcomes, compared with younger women. This finding was more evident in patients >40 years of age, which highlighted the greater risk of fetal death and serious maternal complications in this group.
Topics: Adolescent; Adult; Chi-Square Distribution; Delivery, Obstetric; Female; Fetal Death; Humans; Infant, Newborn; Logistic Models; Maternal Age; Middle Aged; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Risk Factors; Spain; Young Adult
PubMed: 33494983
DOI: 10.1016/j.tjog.2020.11.018 -
Scientific Reports Oct 2022This study aimed to assess the association between interpregnancy interval (IPI)-the time from childbirth to conception of the next pregnancy-and maternal and neonatal...
This study aimed to assess the association between interpregnancy interval (IPI)-the time from childbirth to conception of the next pregnancy-and maternal and neonatal morbidity. The World Health Organization (WHO) currently recommends an IPI of at least 24 months after a live birth to reduce adverse birth outcomes. However, assessing the relationship between IPI and perinatal outcome is complicated by confounding factors. We conducted a nationwide population-based cohort study using Swedish registry data, allowing for adjustment of maternal characteristics and health at first birth. The study population consisted of all women with a singleton, live, and vaginal first birth with a second singleton birth within five years during 1997-2017, covering 327,912 women and 655,824 neonates. IPI was grouped into six-month intervals with 24-29 months as the reference. The association between IPI and morbidity was examined using multivariate logistic regression. For women having a vaginal delivery at their first birth, intervals < 24-29 months were associated with decreased maternal morbidity and unaffected neonatal morbidity. Intervals > 24-29 months were associated with increased maternal and neonatal morbidity. Our findings question the relevance of WHO's recommendation of an IPI of at least 24 months in a high-income country.
Topics: Pregnancy; Infant, Newborn; Humans; Female; Birth Intervals; Cohort Studies; Pregnancy Complications; Live Birth; Logistic Models; Risk Factors; Retrospective Studies; Maternal Age
PubMed: 36258030
DOI: 10.1038/s41598-022-22290-1 -
International Journal of Molecular... Apr 2023It is a well-known fact that the reproductive organs in women, especially oocytes, are exposed to numerous regulatory pathways and environmental stimuli. The maternal... (Review)
Review
It is a well-known fact that the reproductive organs in women, especially oocytes, are exposed to numerous regulatory pathways and environmental stimuli. The maternal age is one cornerstone that influences the process of oocyte fertilization. More precisely, the longer a given oocyte is in the waiting-line to be ovulated from menarche to menopause, the longer the duration from oogenesis to fertilization, and therefore, the lower the chances of success to form a viable embryo. The age of menarche in girls ranges from 10 to 16 years, and the age of menopause in women ranges from approximately 45 to 55 years. Researchers are paying attention to the regulatory pathways that are impacting the oocyte at the very beginning during oogenesis in fetal life to discover genes and proteins that could be crucial for the oocyte's lifespan. Due to the general trend in industrialized countries in the last three decades, women are giving birth to their first child in their thirties. Therefore, maternal age has become an important factor impacting oocytes developmental competence, since the higher a woman's age, the higher the chances of miscarriage due to several causes, such as aneuploidy. Meiotic failures during oogenesis, such as, for instance, chromosome segregation failures or chromosomal non-disjunction, are influencing the latter-mentioned aging-related phenomenon too. These errors early in life of women can lead to sub- or infertility. It cannot be neglected that oogenesis is a precisely orchestrated process, during which the oogonia and primary oocytes are formed, and RNA synthesis takes place. These RNAs are crucial for oocyte growth and maturation. In this review, we intend to describe the relevance of regulatory pathways during the oogenesis in women. Furthermore, we focus on molecular pathways of oocyte developmental competence with regard to maternal effects during embryogenesis. On the background of transcriptional mechanisms that enable the transition from a silenced oocyte to a transcriptionally active embryo, we will briefly discuss the potential of induced pluripotent stem cells.
Topics: Pregnancy; Female; Humans; Maternal Age; Oogenesis; Oocytes; Ovulation; Stem Cells
PubMed: 37047809
DOI: 10.3390/ijms24076837 -
Taiwanese Journal of Obstetrics &... Jul 2021
Topics: Aged; Female; Humans; Maternal Age; Maternal Mortality; Pregnancy; Pregnancy Outcome; Pregnancy, High-Risk; Risk Factors
PubMed: 34247791
DOI: 10.1016/j.tjog.2021.05.001