Research
Obstetrics
Pregnancy outcome at extremely advanced maternal age

https://doi.org/10.1016/j.ajog.2010.07.039Get rights and content

Objective

The purpose of this study was to evaluate pregnancy outcome in women at extremely advanced maternal age (≥45 years).

Study Design

We compared the condition of women aged ≥45 years (n = 177) in a 10:1 ratio (20-29, 30-39, and 40-44 years.). Subgroup analysis compared the condition of women aged 45-49 years with those women aged ≥50 years.

Results

The rates of gestational diabetes mellitus and hypertensive complications were higher for the study group, compared with the whole group (17.0% vs 5.6% and 19.7% vs 4.5%, respectively; P < .001), as was the rate of preterm delivery at <37 and <34 weeks of gestation (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.2–3.6 and OR, 3.5; 95% CI, 1.4–9.0, respectively). The rates of cesarean delivery (OR, 31.8; 95% CI, 18.0–56.1), placenta previa, postpartum hemorrhage, and adverse neonatal outcome were significantly higher among the study group. The risk for gestational diabetes mellitus, preeclampsia toxemia, preterm delivery, and neonatal intensive care unit admission was increased for women aged ≥50 years.

Conclusion

Pregnancy at extreme advanced maternal age is associated with increased maternal and fetal risk.

Section snippets

Methods

The study sample consisted of women who were at least 45 years old at the time of delivery and who gave birth in our hospital between 2000 and 2008. For the purpose of comparison groups, data were compared with 3 control groups, which were matched by maternal age, in a 10:1 ratio (20-29, 30-39, and 40-44 years.). These groups were comprised of the next 10 deliveries for each of the 3 age subgroups after a delivery of a woman at ≥45 years old in the same time period. In addition, we further

Results

During the study period, 79,650 women gave birth in our hospital; 177 of these women (0.2%) were ≥45 years old at the time of delivery.

The demographic and obstetric characteristics for the study and the control groups are given in Table 1. Gravidity and parity and the rates of chronic hypertension and pregestational diabetes mellitus increased all through maternal age categories. The rates of GDM and preeclampsia toxemia in the study group were significantly higher in comparison with the

Comment

Although it is generally uncommon, in the last 3 decades, the prevalence of delaying family planning after the age of 40 years old significantly increased.1 Moreover, because of enormous advances in reproductive medicine and oocyte donation, even postmenopausal women in their 5th and 6th decades of life may become pregnant. As a consequence, gravidity and parity in the last few decades created a unique group of pregnant women in the extreme advanced maternal age. Despite the fact that this

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Authorship and contribution to the article is limited to the 6 authors indicated. There was no outside funding or technical assistance with the production of this article.

Cite this article as: Yogev Y, Melamed N, Tenenbaum-Gavish K, et al. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol 2010;203:558.e1-7.

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