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Scientific Reports Feb 2020To study the effect of very advanced maternal age on perinatal outcomes. A retrospective cohort study of women aged 45 years and above, who delivered ≥22 weeks of...
To study the effect of very advanced maternal age on perinatal outcomes. A retrospective cohort study of women aged 45 years and above, who delivered ≥22 weeks of gestation in a single tertiary center between 1/ 2011 and 12/ 2018. Maternal and neonatal outcomes were compared between women ≥50 years and women of 45-49 years at delivery. Of 83,661 parturients, 593 (0.7%) were 45-49 years old and 64 (0.07%) were ≥50 years old. Obstetrical characteristics were comparable, though the rate of chronic hypertension and preeclampsia with severe features were greater in women ≥50 years (6.2% vs 1.4%, p = 0.04, 15.6% vs 7.0%, p = 0.01, 95% CI 0.19-0.86, respectively). Elective cesarean deliveries were independently associated with advanced maternal age ≥50 (OR 2.63 95% CI 1.21-5.69). Neonatal outcomes were comparable for singletons, but rates of ventilatory support and composite severe neonatal outcomes were higher in twin pregnancies of women ≥50 years (42.8% vs 13.5%, p = 0.01, and 21.4% vs 4.0%, p = 0.03, respectively). Healthy women ≥50 have higher elective cesarean rates, despite similar maternal and neonatal characteristics.
Topics: Delivery, Obstetric; Female; Humans; Infant, Newborn; Maternal Age; Middle Aged; Pregnancy; Pregnancy Outcome; Pregnancy, High-Risk; Retrospective Studies
PubMed: 32020027
DOI: 10.1038/s41598-020-58583-6 -
Medical Science Monitor : International... Apr 2015Fetal sex and maternal age are each known to affect outcomes of pregnancies. The objective of the present study was to investigate the influence of the combination of...
BACKGROUND
Fetal sex and maternal age are each known to affect outcomes of pregnancies. The objective of the present study was to investigate the influence of the combination of maternal age and fetal sex on pregnancy outcomes in term and post-term singleton pregnancies.
MATERIAL AND METHODS
This was a retrospective study on term singleton pregnancies delivered between 2004 and 2008 at the Chaim Sheba Medical Center. Data collected included maternal age, fetal sex, and maternal and neonatal complications. The combined effect of fetal sex and maternal age on complications of pregnancy was assessed by multivariable logistic regression models.
RESULTS
The study population comprised 37,327 pregnancies. The risk of operative deliveries increased with maternal age ≥ 40 and in pregnancies with male fetuses. The risk of maternal diabetes and of longer hospitalization increased as maternal age increased, and in women ≥ 40 carrying male fetuses. The risk of hypertensive disorders increased in pregnancies with males as maternal age advanced. The risk of shoulder dystocia and neonatal respiratory complications increased in male neonates born to women<40. The risk of neonatal hypoglycemia increased in males for all maternal ages.
CONCLUSIONS
Risk assessment for fetal sex and advanced maternal age were given for different pregnancy complications. Knowledge of fetal sex adds value to the risk assessment of pregnancies as maternal age increases.
Topics: Delivery, Obstetric; Female; Humans; Infant, Newborn; Male; Maternal Age; Pregnancy; Pregnancy Outcome; Sex Characteristics
PubMed: 25892459
DOI: 10.12659/MSM.893057 -
Pediatrics May 2023Although mortality rates are highest for infants of teens aged 15 to 19, no studies have examined the long-term trends by race and ethnicity, urbanicity, or maternal...
BACKGROUND AND OBJECTIVES
Although mortality rates are highest for infants of teens aged 15 to 19, no studies have examined the long-term trends by race and ethnicity, urbanicity, or maternal age. The objectives of this study were to examine trends and differences in mortality for infants of teens by race and ethnicity and urbanicity from 1996 to 2019 and estimate the contribution of changes in the maternal age distribution and maternal age-specific (infant) mortality rates (ASMRs) to differences in infant deaths in 1996 and 2019.
METHODS
We used 1996 to 2019 period-linked birth and infant death data from the United States to assess biennial mortality rates per 1000 live births. Pairwise comparisons of rates were conducted using z test statistics and Joinpoint Regression was used to examine trends. Kitagawa decomposition analysis was used to estimate the proportion of change in infant deaths because of changes in the maternal age distribution and ASMRs.
RESULTS
From 1996 to 2019, the mortality rate for infants of teens declined 16.7%, from 10.30 deaths per 1000 live births to 8.58. The decline was significant across racial and ethnic and urbanization subgroups; however, within rural counties, mortality rates did not change significantly for infants of Black or Hispanic teens. Changes in ASMRs accounted for 93.3% of the difference between 1996 and 2019 infant mortality rates, whereas changes in the maternal age distribution accounted for 6.7%.
CONCLUSIONS
Additional research into the contextual factors in rural counties that are driving the lack of progress for infants of Black and Hispanic teens may help inform efforts to advance health equity.
Topics: Adolescent; Humans; Infant; Ethnicity; Hispanic or Latino; Infant Death; Infant Mortality; Maternal Age; United States; Adolescent Mothers; Female; Health Status Disparities; Black or African American
PubMed: 37035875
DOI: 10.1542/peds.2022-060512 -
International Journal of Environmental... Dec 2022To investigate the association between a mother's age and the risk of caesarean section (CS) when controlling for health factors and selected sociodemographic...
OBJECTIVE
To investigate the association between a mother's age and the risk of caesarean section (CS) when controlling for health factors and selected sociodemographic characteristics.
METHODS
Binary logistic regression models for all women who gave birth in Czechia in 2018 (N = 111,749 mothers who gave birth to 113,234 children).
RESULTS
An increase in the age of a mother significantly increases the odds of a CS birth according to all of the models; depending on the model, OR: 1.62 (95% CI 1.54-1.71) to 1.84 (95% CI 1.70-1.99) for age group 35-39 and OR: 2.83 (95% CI 2.60-3.08) to 3.71 (95% CI 3.23-4.27) for age group 40+ compared to age group 25-29. This strong association between the age of a mother and the risk of CS is further reinforced for primiparas (probability of a CS: 11% for age category ≤ 19, 23% for age category 35-39, and 38% for age category 40+). However, the increasing educational attainment of young women appears to have weakened the influence of increasing maternal age on the overall share of CS births; depending on the model, OR: 0.86 (95% CI 0.80-0.91) to 0.87 (95% CI 0.83-0.91) for tertiary-educated compared to secondary-educated women.
CONCLUSIONS
The age of a mother comprises an independent risk factor for a CS birth when the influence of health, socioeconomic, and demographic characteristics is considered.
Topics: Child; Pregnancy; Female; Humans; Cesarean Section; Maternal Age; Parturition; Mothers; Risk Factors
PubMed: 36612987
DOI: 10.3390/ijerph20010668 -
Social Science & Medicine (1982) Jun 2009Maternal age effects on parenting and family outcomes are of increasing interest because of the demographic shift toward older maternal age at first birth. Maternal age...
Maternal age effects on parenting and family outcomes are of increasing interest because of the demographic shift toward older maternal age at first birth. Maternal age is also of interest because of the greater use of assisted reproductive techniques (ART) to bypass age-related infertility in couples trying to conceive late in the reproductive life cycle of the woman. The aim of the present study was to investigate maternal age effects associated with delayed parenting by comparing families of mothers who gave birth at a younger (<31 years) or older (>38 years) age and to ascertain whether associations were linear associations by comparing these groups to women who had conceived in between these ages (i.e., >31 and <38 years). All children (4-11 year olds) were first-born and conceived using ART. Participants were recruited from one of 20 fertility clinics and mothers (n=642) and fathers (n=439) completed a postal questionnaire about demographic and reproductive characteristics, family environment as well as parent and child wellbeing. Our results demonstrate that parenthood via assisted conception later in the reproductive life cycle is not associated with a negative impact on child wellbeing. Despite maternal age-group differences on demographic (education, income) and reproductive characteristics (bleeding during pregnancy, caesarean rate, breast feeding), and parental warmth and depressive symptoms, child wellbeing was similar across mother age groups. We conclude that the parenting context is different for older mother families (more depressive symptoms in mothers and fathers, less expressed warmth in the couple) but that this difference is not associated with child wellbeing in early and middle childhood.
Topics: Adult; Child; Directed Tissue Donation; Family Relations; Female; Fertilization; Humans; Male; Maternal Age; Middle Aged; Personal Satisfaction; Pregnancy; Reproductive Behavior; Reproductive Techniques, Assisted; Surveys and Questionnaires; United Kingdom
PubMed: 19346045
DOI: 10.1016/j.socscimed.2009.02.036 -
Revista Medica de Chile Jan 2005Recent evidence from birth order data suggest that maternal factors can differently influence anencephaly and spina bifida. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Recent evidence from birth order data suggest that maternal factors can differently influence anencephaly and spina bifida.
AIM
To study the influence of maternal age on the risk for neural tube defects.
MATERIAL AND METHODS
A meta-analysis of published data on neural tube defects (NTDs) was carried out to determine whether there is an increased risk to have a child with NTDs for younger and older mothers and if this risk differs depending on the type of NTD. All data available with information regarding the frequency of live births and NTDs cases by maternal age (five- or ten-year intervals) were included in the analysis. Effect sizes calculations were performed.
RESULTS
The analysis supports the hypothesis that there is an increased risk of having an offspring with NTDs for mothers 40 years of age or older. However, this effect is stronger for spina bifida than for anencephaly. There is also evidence that mothers 19 years old or younger have a higher risk for having a child with spina bifida.
CONCLUSIONS
Maternal age influences the risk of having an offspring with neural tube defects.
Topics: Adolescent; Anencephaly; Female; Humans; Maternal Age; Neural Tube Defects; Pregnancy; Risk Factors; Spinal Dysraphism
PubMed: 15768151
DOI: 10.4067/s0034-98872005000100008 -
Zhongguo Dang Dai Er Ke Za Zhi =... Nov 2016To investigate the effect of advanced maternal age on birth defects and postnatal complications of neonates.
OBJECTIVE
To investigate the effect of advanced maternal age on birth defects and postnatal complications of neonates.
METHODS
Among the 1 109 neonates who were born at The First People's Hospital of Yunnan Province between January 2014 and December 2015, 536 neonates whose mothers were aged ≥35 years were enrolled as advanced age group and 573 neonates whose mothers were aged <35 years were enrolled as appropriate-age group. The incidences of the comorbidities in pregnancy, fetal intrauterine distress, neonatal birth defects, and postnatal complications were compared between the two groups. A univariate logistic regression analysis was performed to analyze the effect of advanced maternal age on neonatal comorbidities during perinatal period.
RESULTS
Compared with the appropriate-age group, the advanced age group had significantly higher rate of caesarean section and incidence rates of multiple birth, gestational diabetes, pregnancy-induced hypertension, in vitro fertilization, and fetal intrauterine distress (P<0.01). The neonates in the advanced age group had a significantly higher incidence rate of cleft lip and palate and a significantly lower rate of skeletal dysplasia than in the appropriate-age group (P<0.05). Advanced maternal age was the risk factor for fetal intrauterine distress (OR=2.27, 95%CI: 1.33-3.88, P=0.003), neonatal resuscitation (OR=1.66, 95%CI: 1.19-2.31, P=0.003), and intracranial hemorrhage (OR=2.70, 95%CI: 1.21-6.04, P=0.02).
CONCLUSIONS
The women of maternal advanced age have higher incidence rates of pregnancy comorbidities than those of appropriate age, and the neonates born to the mothers of advanced maternal age have a higher incidence rate of cleft lip and palate. Advanced maternal age may increase the risks of fetal intrauterine distress, neonatal resuscitation, and intracranial hemorrhage.
Topics: Adult; Cerebral Hemorrhage; Cesarean Section; Congenital Abnormalities; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Logistic Models; Maternal Age; Middle Aged; Pregnancy; Pregnancy Complications
PubMed: 27817770
DOI: 10.7499/j.issn.1008-8830.2016.11.006 -
American Journal of Public Health Oct 2013We sought evidence to support the hypothesis that advancing maternal age is potentially causing a rise in preterm birth (PTB) rates in high-income countries.
OBJECTIVES
We sought evidence to support the hypothesis that advancing maternal age is potentially causing a rise in preterm birth (PTB) rates in high-income countries.
METHODS
We assessed maternal age-specific trends in PTB using all singleton live births in Denmark (n = 1 674 308) and Quebec (n = 2 291 253) from 1981 to 2008. We decomposed the country-specific contributions of age-specific PTB rates and maternal age distribution to overall PTB rates over time.
RESULTS
PTB rates increased from 4.4% to 5.0% in Denmark and from 5.1% to 6.0% in Quebec. Rates increased the most in women aged 20 to 29 years, whereas rates decreased or remained stable in women aged 35 years and older. The overall increase over time was driven by age-specific PTB rates, although the contribution of younger women was countered by fewer births at this age in both Denmark and Quebec.
CONCLUSIONS
PTB rates increased among women aged 20 to 29 years, but their contribution to the overall PTB rates was offset by older maternal age over time. Women aged 20 to 29 years should be targeted to reduce PTB rates, as potential for prevention may be greater in this age group.
Topics: Adult; Age Factors; Denmark; Female; Humans; Infant, Newborn; Maternal Age; Premature Birth; Quebec; Young Adult
PubMed: 23947312
DOI: 10.2105/AJPH.2013.301523 -
Proceedings. Biological Sciences Aug 2020Maternal senescence is the detrimental effect of increased maternal age on offspring performance. Despite much recent interest given to describing this phenomenon, its...
Maternal senescence is the detrimental effect of increased maternal age on offspring performance. Despite much recent interest given to describing this phenomenon, its distribution across animal species is poorly understood. A review of the published literature finds that maternal age affects pre-adult survival in 252 of 272 populations (93%) representing 97 animal species. Age effects tended to be deleterious in invertebrates and mammals, including humans, confirming the presence of senescence. However, bird species were a conspicuous exception, as pre-adult survival tended to increase with maternal age in surveyed populations. In all groups, maternal-age effects became more negative in older mothers. Invertebrates senesced faster than vertebrates, and humans aged faster than non-human mammals. Within invertebrates, lepidopterans demonstrated the most extreme rates of maternal-effect senescence. Among the surveyed studies, phylogeny, life history and environment (e.g. laboratory versus wild populations) were tightly associated; this made it difficult to make confident inferences regarding the causes of diversity for the phenomenon. However, we provide some testable suggestions, and we observe that some differences appear to be consistent with predictions from evolutionary theory. We discuss how future work may help clarify ultimate and proximate causes for this diversity.
Topics: Animals; Biodiversity; Biological Evolution; Female; Humans; Invertebrates; Mammals; Maternal Age; Maternal Inheritance
PubMed: 32781953
DOI: 10.1098/rspb.2020.0972 -
Biology of Sex Differences Apr 2020The average age at first birth is steadily increasing in developed countries; however, demographic shifts in maternal age at childbearing have not occurred in isolation....
BACKGROUND
The average age at first birth is steadily increasing in developed countries; however, demographic shifts in maternal age at childbearing have not occurred in isolation. While temporal increases in adverse pregnancy outcomes are typically attributed to increases in maternal age, little is known about how maternal health status has changed across maternal age, period of delivery, and birth cohort.
METHODS
Natality files were used to identify primiparous women delivering liveborn, singleton infants in the USA in 1989, 1994, 1999, 2004, 2009, and 2014 (n = 6,857,185). Age-period-cohort models using the intrinsic estimator adjusted for temporal trends in smoking and gestational weight gain were used to quantify temporal changes in the rates of pre-existing (chronic hypertension, pre-existing diabetes) and pregnancy-associated (pregnancy-associated hypertension, gestational diabetes, eclampsia) diseases. Log-linear models were used to model the impact of temporal changes on preterm birth, small, and large for gestational age (SGA/LGA) births.
RESULTS
Significant period effects resulted in temporal increases in the rate of chronic hypertension, pregnancy-associated hypertension, and gestational diabetes, and a significant decrease in the rate of eclampsia. These observed period effects were associated with a 10.6% increase in the rate of SGA and a 7.1% decrease in LGA. Had the rate of pre-existing and pregnancy-associated diseases remained static over this time period, the rate of preterm birth would have increased by 5.9%, but instead only increased by 4.4%.
CONCLUSIONS
Independent of changes in the incidence of pre-existing and pregnancy-associated diseases as women age, the obstetric population is becoming less healthy over time. This is important, as these changes have a direct negative impact on short-term obstetric outcomes and women's long-term health.
Topics: Adolescent; Adult; Cohort Effect; Female; Humans; Maternal Age; Middle Aged; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Young Adult
PubMed: 32307020
DOI: 10.1186/s13293-020-00293-9