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Acta Medica Portuguesa Mar 2019The risks of pregnancy in women of advanced maternal age are not consensual amongst studies. The aim of this metaanalysis was to determine whether women of advanced... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The risks of pregnancy in women of advanced maternal age are not consensual amongst studies. The aim of this metaanalysis was to determine whether women of advanced maternal age (≥ 35 years old) had worse obstetrical and perinatal outcomes than non- advanced maternal age women (20 - 34 years old) in singleton, naturally-conceived pregnancies.
MATERIAL AND METHODS
We searched PubMed/ MEDLINE, IndexRMP and the Cochrane Database of Systematic Reviews. Ten studies were included according to the following criteria: population of > 1000 nulliparous and/or multiparous women with singleton gestations who did not undergo any type of infertility treatment. Using Review Manager v. 5.3, two meta-analysis were performed: one comparing the outcomes of 20 - 34-year-old vs 35 - 40-year-old women, and another comparing the outcomes of 35 - 40-year-old women vs > 40-year-old women.
RESULTS
Women aged 35 - 40 years old were more likely to have > 12 years of education than 20 - 34 years old and > 40 years old women. Advanced maternal age women (35 - 40 and > 40 years old) were more likely to be overweight and having gestational diabetes and gestational hypertension. They were also more likely to undergo induced labour and elective caesarean deliveries. Furthermore, they had worse perinatal outcomes such as preterm delivery, low birthweight babies, higher rates of Neonatal Intensive Care Unit admission and worse Apgar scores. Advanced maternal age women had higher rates of perinatal mortality and stillbirth.
DISCUSSION
Most authors present similar results to our study. Although the majority of adverse outcomes can be explained through the physio-pathological changes regarding the female reproductive apparatus that come with aging and its inherent comorbidities, according to the existing literature advanced maternal age can be an independent risk factor per se. In older pregnant women without comorbidities such as gestational hypertension or diabetes there are still worse obstetric and perinatal outcomes, which indicate that advanced maternal age is an independent strong risk factor alone.
CONCLUSION
Advanced maternal age women are at a higher risk of adverse obstetrical and perinatal outcomes. In both comparisons, worse outcomes were more prevalent in the older group, suggesting that poorer outcomes are more prevalent with increasing age.
Topics: Adult; Cesarean Section; Diabetes, Gestational; Female; Humans; Labor, Induced; Maternal Age; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Stillbirth; Young Adult
PubMed: 30946794
DOI: 10.20344/amp.11057 -
National Vital Statistics Reports :... Jan 2023Objectives-This report presents 2021 data on U.S. births according to a variety of characteristics. Trends in fertility patterns and maternal and infant characteristics...
Objectives-This report presents 2021 data on U.S. births according to a variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted.
Topics: Pregnancy; Female; Adolescent; Humans; United States; Maternal Age; Pregnancy in Adolescence; Birth Rate; Birth Certificates; Parturition
PubMed: 36723449
DOI: No ID Found -
Journal of Women's Health (2002) Feb 2021Although the influence of advanced maternal age (AMA) and delayed childbearing on adverse maternal and perinatal outcomes has been studied extensively, no universal...
Although the influence of advanced maternal age (AMA) and delayed childbearing on adverse maternal and perinatal outcomes has been studied extensively, no universal consensus on the definition of AMA exists. This terminology currently refers to the later years of a woman's reproductive life span and generally applies to women age ≥35 years. AMA increases the risk of pregnancy complications, including ectopic pregnancy, spontaneous abortion, fetal chromosomal abnormalities, congenital anomalies, placenta previa and abruption, gestational diabetes, preeclampsia, and cesarean delivery. Such complications could be the cause of preterm birth and increase the risk of perinatal mortality. For women who have a chronic illness, pregnancy may lead to additional risk that demands increased monitoring or surveillance. The management of pregnant women of AMA requires understanding the relationship between age and preexisting comorbidities. The outcomes from pregnancy in AMA may have a negative impact on women's health as they age because of both the changes from the pregnancy itself and the increased risk of pregnancy-related complications. Postpartum depression affects women of AMA at higher rates. Links between preeclampsia and the risk of future development of cardiovascular disease require follow-up surveillance. The association between hypertensive pregnancy disorders and cognitive and brain functions needs further investigation of sex-specific risk factors across the life span. Educating providers and women of AMA is crucial to facilitate clinical decision making and such education should consider cultural influences, risk perception, and women's health literacy, as well as providers' biases and system issues.
Topics: Adult; Female; Humans; Infant, Newborn; Male; Maternal Age; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy, High-Risk; Premature Birth
PubMed: 33185505
DOI: 10.1089/jwh.2020.8860 -
National Vital Statistics Reports :... Feb 2021Objectives-This report presents 2020 data on U.S. births according to a wide variety of characteristics. Trends in fertility patterns and maternal and infant...
Objectives-This report presents 2020 data on U.S. births according to a wide variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted.
Topics: Adolescent; Birth Certificates; Birth Rate; Female; Humans; Maternal Age; Parturition; Pregnancy; Pregnancy in Adolescence; United States
PubMed: 35157571
DOI: No ID Found -
Redox Biology Jan 2021
Topics: Aneuploidy; Female; Follicular Fluid; Humans; Maternal Age; Melatonin; Oocytes
PubMed: 33341428
DOI: 10.1016/j.redox.2020.101831 -
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 -
Aging Feb 2023Female fertility decreases with age. A decline in oocyte quality plays a key role in reproductive problems in older women. Whether advanced maternal age (AMA) is... (Meta-Analysis)
Meta-Analysis
Female fertility decreases with age. A decline in oocyte quality plays a key role in reproductive problems in older women. Whether advanced maternal age (AMA) is associated with a decline in endometrial receptivity (ER) remains controversial. A systematic review and meta-analysis were conducted to evaluate the relationship between AMA and ER. Eighteen eligible studies were included in this meta-analysis. Of the 18 studies, 17, 8, 14, and 9 studies reported the impact of AMA on clinical pregnancy rate (CPR), implantation rate (IR), miscarriage rate (MR), and live birth rate (LBR), respectively. The combined results showed a trend (without significance) toward lower CPR in women with AMA than in younger women. A similar trend of worse outcomes in terms of IR was observed in women with AMA. A significantly higher MR and lower LBR were observed in infertile women with AMA than in younger women. In conclusion, there was a slightly lower IR and CPR without significance; however, significantly increased MR and decreased LBR were observed in women with AMA than in younger women, indicating that AMA is related to the decline of ER. Further prospective cohort studies with a preimplantation genetic testing for aneuploidy model are needed to observe the relationship between AMA and ER and explore the possible mechanisms.
Topics: Pregnancy; Humans; Female; Maternal Age; Pregnancy Rate; Infertility, Female; Prospective Studies; Embryo Implantation; Abortion, Spontaneous
PubMed: 37036802
DOI: 10.18632/aging.204555 -
Aging Jul 2022
Topics: Aging; Female; Humans; Maternal Age; Placenta; Pregnancy
PubMed: 35853249
DOI: 10.18632/aging.204175 -
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 -
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