Delayed childbearing is increasingly common; hence, concerns emerge regarding potential for additional risks of delivery at advanced maternal age (AMA; ≥35 years). In this study, we sought to assess impact of AMA and parity on maternal and perinatal outcomes.
MethodsIn this retrospective single-center study (July 2005 to October 2011), we compared spontaneously-conceived singleton births of AMA mothers with spontaneously-conceived singletons of mothers aged 24–27 years. Maternal outcomes: incidence of diabetes, hypertension, and emergency cesarean sections (ECS). Neonatal outcomes: prematurity, birth weight, incidence of small or large for gestational age infants (SGA/LGA, respectively), low birth weight (LBW), and 5′-Apgar scores. Sub-groupings of maternal age were 35–38, 39–42, or 43–47 years; prematurity as <34 or <37 weeks; AMA parity as primiparous, 2–5 births, 6–9 births, or ≥10 births. Binary logistic regression was used for multivariate analyses.
ResultsOf 24,579 eligible women, 11,243 were AMA (14.0 % total singleton births) and 13,336 were aged 24–27 years (16.7 % total singleton births) at delivery. There were no maternal or perinatal deaths. Incidence of maternal hypertension and diabetes was significantly greater in AMA, especially oldest AMA. AMA including primiparous had significantly more ECS than younger including primiparous controls, respectively, and were more likely to deliver LGA neonates. Primiparous AMA women did not have increased incidence of LGA babies but significantly increased incidence of SGA infants.
ConclusionAMA, especially primiparous, has more adverse maternal and neonatal outcomes than younger women; however, these did not include mortality. Consistent antenatal care may explain this.
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The authors would like to acknowledge the technical assistance of Ms. Rivka Farkash and Mr. Maymone Dahan of the SZMC Computer Services Department in accessing the archival material.
Conflict of interestNone of the authors have any conflicts of interest to report. No special funding was received for the performance of this study.
Author information Authors and AffiliationsDepartment of Neonatology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, Hadassah Medical School, Jerusalem, Israel
Michael S. Schimmel, Ruben Bromiker & Cathy Hammerman
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, Hadassah Medical School, P.O. Box 3235, 12 Bayit Street, 91031, Jerusalem, Israel
Lila Chertman, Sorina Granovsky-Grisaru, Arnon Samueloff & Deborah Elstein
Department of Anesthesiology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, Hadassah Medical School, Jerusalem, Israel
Alexander Ioscovich
Correspondence to Deborah Elstein.
Additional informationThis paper was presented (in part) at the Annual Meeting, Society of Pediatric Research, May 2012, Boston, MA USA.
About this article Cite this articleSchimmel, M.S., Bromiker, R., Hammerman, C. et al. The effects of maternal age and parity on maternal and neonatal outcome. Arch Gynecol Obstet 291, 793–798 (2015). https://doi.org/10.1007/s00404-014-3469-0
Received: 05 January 2014
Accepted: 10 September 2014
Published: 17 September 2014
Issue Date: April 2015
DOI: https://doi.org/10.1007/s00404-014-3469-0
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