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International Journal of Epidemiology Feb 2023Advanced maternal age at birth is considered a risk factor for adverse birth outcomes. A recent study applying a sibling design has shown, however, that the association...
BACKGROUND
Advanced maternal age at birth is considered a risk factor for adverse birth outcomes. A recent study applying a sibling design has shown, however, that the association might be confounded by unobserved maternal characteristics.
METHODS
Using total population register data on all live singleton births during the period 1999-2012 in Denmark (N = 580 133; 90% population coverage), Norway (N = 540 890) and Sweden (N = 941 403) and from 2001-2014 in Finland (N = 568 026), we test whether advanced maternal age at birth independently increases the risk of low birthweight (LBW) (<2500 g) and pre-term birth (<37 weeks gestation). We estimated within-family models to reduce confounding by unobserved maternal characteristics shared by siblings using three model specifications: Model 0 examines the bivariate association; Model 1 adjusts for parity and sex; Model 2 for parity, sex and birth year.
RESULTS
The main results (Model 1) show an increased risk in LBW and pre-term delivery with increasing maternal ages. For example, compared with maternal ages of 26-27 years, maternal ages of 38-39 years display a 2.2, 0.9, 2.1 and 2.4 percentage point increase in the risk of LBW in Denmark, Finland, Norway and Sweden, respectively. The same patterns hold for pre-term delivery.
CONCLUSIONS
Advanced maternal age is independently associated with higher risk of poor perinatal health outcomes even after adjusting for all observed and unobserved factors shared between siblings.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Adult; Maternal Age; Birth Weight; Infant, Low Birth Weight; Parity; Risk Factors
PubMed: 36350574
DOI: 10.1093/ije/dyac211 -
Neuroscience Letters Jul 2022Extended maternal age has been suggested as marker of delayed age-associated disabilities. We use the Long Life Family Study (LLFS) offspring generation to investigate...
Extended maternal age has been suggested as marker of delayed age-associated disabilities. We use the Long Life Family Study (LLFS) offspring generation to investigate the association between extended maternal age at last childbirth and healthy-aging endophenotypes. We hypothesize that women with extended maternal age at last childbirth will exhibit healthier endophenotype profiles compared to younger mothers. The association between maternal age and age-related endophenotypes previously derived in LLFS was assessed using Generalized Estimating Equations to adjust for relatedness. The quartiles of the maternal age at last childbirth were modeled as the independent variables. Univariate analyses tested the association between maternal age at last childbirth and age at clinical assessment, education, field center, Apolipoprotein E (APOE) genotype, depression, stress, smoking and successful pregnancies. Only the variables significantly associated in the univariate analyses were considered in secondary multivariate analyses. Univariate analyses showed that compared to older mothers (age at last birth ≥35), mothers 30 years old or younger at last childbirth are less educated (12 ± 3 years versus 13 ± 3 years) and have a higher frequency of smoking (9% versus 3% for maternal age ≥35). Results showed that older mothers (age at last birth ≥31-34 or ≥ 35) demonstrated significantly better cognitive profiles (p = 0.017 and p = 0.021 respectively) compared with mothers with last childbirth age ≤30. Later maternal age among women from long-life families is associated with a better cognitive profile, supporting the hypothesis that later age at childbirth may be a marker for healthy aging.
Topics: Adult; Educational Status; Endophenotypes; Female; Humans; Maternal Age; Mothers; Pregnancy; Smoking
PubMed: 35709880
DOI: 10.1016/j.neulet.2022.136737 -
Prenatal Diagnosis Aug 2021To determine the ratio of dichorionic (DC) to monochorionic (MC) twins by maternal age.
OBJECTIVE
To determine the ratio of dichorionic (DC) to monochorionic (MC) twins by maternal age.
METHODS
We reviewed all twin pregnancies undergoing first trimester screening (FTS) with nuchal translucency from April 2009 to December 2012 with sonographic determination of chorionicity. Cases were linked to newborn screening (NBS) results and zygosity estimated based on rates of fetal sex discordance. The ratio of DC to MC placentation by maternal age was calculated.
RESULTS
We identified 11,351 twin pregnancies with FTS and documented chorionicity. Among these, 7,861 (64.2%) had linked data on FTS and NBS to allow estimation of zygosity based on neonatal sex. Of these, 1,464 (18.6%) were MC and 6,406 (81.4%) DC. The MC twin rate remained constant while the DC twin rate increased with maternal age until 40y. At < 20y, 55% of twin pregnancies were monozygotic (MZ), as compared to 29% at ≥ 40y. Of MZ twins, 38% were DC at < 20y, while 53% were DC at ≥ 40y.
CONCLUSIONS
Our data suggest a relationship of both zygosity and chorionicity with maternal age. DZ twinning increased with maternal age, while among MZ twins, the proportion that were DC also increased with maternal age.
Topics: Chorion; Female; Gestational Age; Humans; Infant, Newborn; Maternal Age; Pregnancy; Pregnancy, Twin; Twins, Dizygotic; Twins, Monozygotic
PubMed: 35280337
DOI: 10.1002/pd.5997 -
Advanced maternal age and severe maternal morbidity in South Korea: a population-based cohort study.Scientific Reports Dec 2022To investigate the association between maternal age and severe maternal morbidity (SMM) in a Korean population. Data for cases of delivery between 2003 and 2019 were...
To investigate the association between maternal age and severe maternal morbidity (SMM) in a Korean population. Data for cases of delivery between 2003 and 2019 were extracted from the Korean National Health Insurance Service-National Delivery Cohort. The main outcome was SMM, which was determined using the Center for Disease Control and Prevention's algorithm. A generalized estimating equation model with a log link was performed for the relationship between SMM and maternal age adjusted for covariates. SMM occurred in 40,959/2,113,615 (1.9%) of delivery cases. Teenagers and women 35 years and older had an increased risk of SMM in both nulliparous and multiparous cases (ages 15-19: risk ratio (RR) 1.32, 95% confidence interval (CI) 1.15-1.46; ages 35-39: RR 1.24, 95% CI 1.21-1.28; ages 40-44: RR 1.57, 95% CI 1.50-1.64; and ages 45 or older: RR 2.07, 95% CI 1.75-2.44). Women aged 40 years and older had the highest rates of SMM. In singleton births as well as in nulliparous and multiparous cases, teenagers and women aged 35 years and older had a particularly high risk of SMM. Identifying and managing risk factors for SMM in these vulnerable age groups may improve maternal health outcomes.
Topics: Pregnancy; Adolescent; Female; Humans; Adult; Middle Aged; Maternal Age; Cohort Studies; Risk Factors; Parity; Republic of Korea; Morbidity; Retrospective Studies
PubMed: 36494399
DOI: 10.1038/s41598-022-25973-x -
Frontiers in Cellular and Infection... 2022The distribution of the microbiome in women with advanced maternal age (AMA) is poorly understood. To gain insight into this, the vaginal and gut microbiota of 62 women...
The distribution of the microbiome in women with advanced maternal age (AMA) is poorly understood. To gain insight into this, the vaginal and gut microbiota of 62 women were sampled and sequenced using the 16S rRNA technique. These women were divided into three groups, namely, the AMA (age ≥ 35 years, = 13) group, the non-advanced maternal age (NMA) (age < 35 years, = 38) group, and the control group (non-pregnant healthy women, age >35 years, = 11). We found that the alpha diversity of vaginal microbiota in the AMA group significantly increased. However, the beta diversity significantly decreased in the AMA group compared with the control group. There was no significant difference in the diversity of gut microbiota among the three groups. The distributions of microbiota were significantly different among AMA, NMA, and control groups. In vaginal microbiota, the abundance of was higher in the pregnant groups. was significantly enriched in the AMA group. In gut microbiota, was significantly enriched in the AMA group. Vaginal and gut microbiota in women with AMA were noticeably different from the NMA and non-pregnant women, and this phenomenon is probably related to the increased risk of complications in women with AMA.
Topics: Adult; Female; Gastrointestinal Microbiome; Humans; Maternal Age; Microbiota; Pregnancy; RNA, Ribosomal, 16S; Vagina
PubMed: 35694547
DOI: 10.3389/fcimb.2022.819802 -
Scientific Reports Jan 2021Advanced maternal age (AMA) is a growing trend world-wide and is traditionally defined as childbearing in women over 35 years of age. The purpose of our study was to...
Advanced maternal age (AMA) is a growing trend world-wide and is traditionally defined as childbearing in women over 35 years of age. The purpose of our study was to determine the maternal age group within the Korean population, in which the risk of early neonatal mortality is increased. Korean birth and mortality data from 2011 to 2015 were used to estimate the influence of maternal age on the risk of early neonatal mortality. A Poisson regression was used for the analysis of multiple clinical variables such as year of delivery, maternal age, gestational age, infant gender, birth weight, multiple birth, parity, and socioeconomic variables. Furthermore, a generalized additive model was used to determine the maternal age at which the risk for neonatal mortality increases. We included 2,161,908 participants and found that 49.4% of mothers were 30-34 years of age at delivery. The proportion of mothers aged 35 and above increased over the 5-year analysis period. A maternal age lower than 29 years or higher than 40 years was associated with a relatively higher risk of early neonatal mortality. The trend and magnitude of the age-related risk on early neonatal mortality were independent of maternal socioeconomic factors such as living in an obstetrically underserved area, education level, and employment status. Furthermore, we showed that the risk for early neonatal mortality was higher until the maternal age of 28. However, there were no significant changes in the risk between the age of 35 and 40 years. According to recent national-wide data, age-related risk for early neonatal mortality is only apparent for mothers ≥ 40 years old whereas, age between 35 and 39 are not at increased risk for early neonatal mortality, despite being classified as AMA.
Topics: Adult; Birth Weight; Cohort Studies; Databases, Factual; Female; Gestational Age; Humans; Infant; Infant Mortality; Maternal Age; Parity; Pregnancy; Pregnancy, Multiple; Republic of Korea; Risk Factors; Young Adult
PubMed: 33436971
DOI: 10.1038/s41598-021-80968-4 -
Revista Brasileira de Ginecologia E... Mar 2023This study assessed maternal mortality (MM) and related factors in a large-sized municipality in the Southeastern region of Brazil (Campinas, São Paulo) during the...
OBJECTIVE
This study assessed maternal mortality (MM) and related factors in a large-sized municipality in the Southeastern region of Brazil (Campinas, São Paulo) during the period 2000-2015.
METHODS
This study consisted of two phases: 1. An analytical nested case-control phase that assessed the impact of individual and contextual variables on MM; and 2. an ecological phase designed to contextualize maternal deaths by means of spatial analysis. The case group consisted of all maternal deaths (n = 87) and the control group consisted of 348 women who gave birth during the same period. Data analysis included descriptive statistics, association, and multiple logistic regression (MLR) tests at p < 0.05 as well as spatial analysis.
RESULTS
Maternal Mortality Ratio was 37 deaths per 100.000 live births. Deaths were dispersed throughout the urban territory and no formation of cluster was observed. MLR showed that pregnant women aged ≥ 35 years old (OR = 2.63) or those with cesarean delivery (OR = 2.51) were more prone to maternal death.
CONCLUSION
Maternal deaths were distributed dispersedly among the different socioeconomic levels and more prone to occur among older women or those undergoing cesarean deliveries.
Topics: Adult; Aged; Female; Humans; Pregnancy; Brazil; Cesarean Section; Maternal Age; Maternal Death; Maternal Mortality; Parturition; Delivery, Obstetric; Case-Control Studies
PubMed: 37105197
DOI: 10.1055/s-0043-1768456 -
BMC Endocrine Disorders Jun 2024Advanced maternal age may affect the intrauterine environment and increase the risk of neurodevelopmental disorders in offspring. Thyroid hormones are critical for fetal...
BACKGROUND
Advanced maternal age may affect the intrauterine environment and increase the risk of neurodevelopmental disorders in offspring. Thyroid hormones are critical for fetal neurological development but whether maternal age influences fetal thyroid hormone levels in euthyroid mothers is unknown.
OBJECTIVE
This study evaluated the association between cord blood thyroid hormones and maternal age, fetal sex, maternal thyroid function, and other perinatal factors.
METHODS
The study population consisted of 203 healthy women with term singleton pregnancies who underwent elective cesarean section. Maternal levels of free T3 (fT3), free T4 (fT4) and TSH before delivery, and cord levels of fT3, fT4 and TSH were measured. Spearman's correlation coefficient and multiple linear regression analyses were performed to determine the correlation between cord thyroid hormone parameters and maternal characteristics.
RESULTS
There were no significant differences in maternal serum or cord blood thyroid hormone levels between male and female births. In multivariate linear regression analysis, maternal age and maternal TSH values were negatively associated with the cord blood levels of fT3 in all births, after adjusting for confounding factors. Maternal age was more closely associated with the cord blood levels of fT3 in female than in male births.
CONCLUSION
The inverse association between maternal age and cord blood levels of fT3 in euthyroid pregnant women suggested an impact of maternal aging on offspring thyroid function.
Topics: Humans; Female; Maternal Age; Adult; Male; Pregnancy; Fetal Blood; Infant, Newborn; Triiodothyronine; Sex Factors; Thyroid Function Tests; Thyrotropin
PubMed: 38926806
DOI: 10.1186/s12902-024-01631-3 -
Scientific Reports Aug 2023This study aimed to clarify the relationship between maternal mortality and advanced maternal age in Japan and to provide useful information for future perinatal...
This study aimed to clarify the relationship between maternal mortality and advanced maternal age in Japan and to provide useful information for future perinatal management. Maternal death rates by age group were investigated for all maternal deaths in Japan for an 11-year period, from 2010 to 2021. Maternal deaths among those aged ≥ 40 years were examined in detail to determine the cause, and the number of deaths by cause was calculated. The causes of onset of the most common causes of death were also investigated. The maternal mortality rates were 0.8 (95% confidence interval [CI] 0.3-4.7) for < 20 years, 2.6 (95% CI 1.7-3.8) for 20-24 years, 2.9 (95% CI 2.3-3.6) for 25-29 years, 3.9 (95% CI 3.3-4.5) for 30-34 years, 6.8 (95% CI 5.9-7.9) for 35-39 years, and 11.2 (95% CI 8.8-14.3) for ≥ 40 years of age. Patients who were ≥ 40 years of age had a significantly higher mortality rate compared to that in other age groups. Hemorrhagic stroke was the most common cause of death in patients aged ≥ 40 years (15/65 [23%]), and preeclampsia (8/15 [54%]) was the most common cause of hemorrhagic stroke. Maternal mortality is significantly higher in older than in younger pregnant women in Japan, with hemorrhagic stroke being the most common cause of maternal death among women > 40 years of age. More than half of hemorrhagic strokes are associated with hypertension disorder of pregnancy. These facts should be considered by women who become pregnant at an advanced age and by healthcare providers involved in their perinatal care.
Topics: Pregnancy; Humans; Female; Aged; Adult; Maternal Age; Maternal Death; Maternal Mortality; Hemorrhagic Stroke; Japan
PubMed: 37558813
DOI: 10.1038/s41598-023-40150-4 -
Medicina (Kaunas, Lithuania) Sep 2019: Adverse cardiovascular outcomes during pregnancy have increased over the past few decades, with increased numbers of women delivering later in their reproductive life.... (Review)
Review
: Adverse cardiovascular outcomes during pregnancy have increased over the past few decades, with increased numbers of women delivering later in their reproductive life. Other factors include higher rates of female obesity, diabetes, hypertension, cardiovascular diseases and assisted reproductive technology, which has extended fertility. Those at risk require extensive prenatal maternal screening, constant pregnancy supervising, monitoring during labor, delivery and puerperium and careful anesthetic evaluation during delivery. : The present review reports the relevant information available on cardiovascular outcomes in advanced maternal age delivering women and related medico-legal issues. The search was performed on Pubmed, Cochrane, Semantic Scholar, Medline and Embase databases, accessed by Ovid, including among others the terms "cardiomyopathy", "ischaemic heart disease", "arrhythmias", "hypertension", "peripartum period", "diabetes", "advanced maternal age" "anesthesia", "maternal morbidity and mortality" and "litigation". : To the extent that underestimating risk factors for peripartum cardiomyopathy (PPCM) can adversely impact maternal and fetal outcomes, the legal implications of misdiagnosis or mismanagement can result in high compensatory damages. Substantial indemnity payments drive up costs of insurance coverage. : Multidisciplinary approaches are necessary from obstetricians, cardiologists, anesthesiologists and perinatologists for pregnancy monitoring and delivery outcomes.
Topics: Adult; Cardiovascular Diseases; Female; Humans; Liability, Legal; Maternal Age; Middle Aged; Pregnancy; Pregnancy Complications, Cardiovascular; Risk Factors
PubMed: 31569595
DOI: 10.3390/medicina55100658