Risk of adverse pregnancy outcomes of late‐ and postterm pregnancies in advanced maternal age: A national cohort study
| Autor: | Esteriek de Miranda, Aafke Bruinsma, Jeroen van Dillen, Judit K. J. Keulen, Ben W.J. Mol, Frank P.H.A. Vandenbussche, Joep C. Kortekaas, Brenda M. Kazemier |
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| Přispěvatelé: | Obstetrics and Gynaecology, Graduate School, ARD - Amsterdam Reproduction and Development, APH - Personalized Medicine, APH - Methodology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
induction of labor medicine.medical_specialty Adolescent morbidity 03 medical and health sciences 0302 clinical medicine Obstetrics and gynaecology Risk Factors Pregnancy Intensive Care Units Neonatal Sepsis Meconium aspiration syndrome Humans Medicine Pregnancy Prolonged Registries 030212 general & internal medicine Advanced maternal age Original Research Article Fetal Death Netherlands 030219 obstetrics & reproductive medicine business.industry Obstetrics Other Research Radboud Institute for Health Sciences [Radboudumc 0] Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Gestational age General Medicine Middle Aged medicine.disease mortality Confidence interval Meconium Aspiration Syndrome Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] postpartum hemorrhage maternal age Relative risk Apgar Score Female Apgar score stillbirth delivery business adverse pregnancy outcome cesarean |
| Zdroj: | Acta Obstetricia et Gynecologica Scandinavica Acta Obstetricia et Gynecologica Scandinavica, 99, 1022-1030 Acta Obstetricia et Gynecologica Scandinavica, 99, 8, pp. 1022-1030 Acta obstetricia et gynecologica Scandinavica, 99(8), 1022-1030. Wiley-Blackwell |
| ISSN: | 1600-0412 0001-6349 |
| Popis: | Contains fulltext : 225379.pdf (Publisher’s version ) (Open Access) INTRODUCTION: There is an increase in women delivering ≥35 years of age. We analyzed the association between advanced maternal age and pregnancy outcomes in late- and postterm pregnancies. MATERIAL AND METHODS: A national cohort study was performed on obstetrical low-risk women using data from the Netherlands Perinatal Registry from 1999 to 2010. We included women ≥18 years of age with a singleton pregnancy at term. Women with a pregnancy complicated by congenital anomalies, hypertensive disorders or diabetes mellitus were excluded. Composite adverse perinatal outcome was defined as stillbirth, neonatal death, meconium aspiration syndrome, 5-minute Apgar score 1000 mL. RESULTS: We stratified the women into three age groups: 18-34 (n = 1 321 366 [reference]); 35-39 (n = 286 717) and ≥40 (n = 40 909). Composite adverse perinatal outcome occurred in 1.6% in women aged 18-34, 1.7% in women aged 35-39 (relative risk [RR] 1.06, 95% confidence interval [95% CI] 1.03-1.08) and 2.2% in women aged ≥40 (RR 1.38, 95% CI 1.29-1.47), with 5-minute Apgar score 1000 mL as the factor contributing most to the outcome. In all age categories, the risk of adverse pregnancy outcomes was higher for nulliparous than for multiparous women. The risk of adverse outcomes increased in both nulliparous and parous women with advancing gestational age. When adjusted for parity, onset of labor and gestational age, advanced maternal age is associated with an increase in both composite adverse perinatal and maternal outcomes. CONCLUSIONS: The risk of adverse pregnancy outcome increases with advancing maternal age. Women aged ≥40 have an increased risk of adverse perinatal and maternal outcome when pregnancy goes beyond 41 weeks. |
| Databáze: | OpenAIRE |
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