Very advanced maternal age: Pregnancy after age 45
| Autor: | Gary A. Dildy, G K Fowers, Bryan T. Oshiro, Michael W. Varner, Jackson Gm, Steven L. Clark |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Neonatal intensive care unit Pregnancy High-Risk Birth weight Reproductive Techniques Pregnancy Prenatal Diagnosis Intensive care Infant Mortality Fetal distress medicine Birth Weight Humans Sex Ratio Advanced maternal age Retrospective Studies Obstetrics business.industry Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Gestational age Length of Stay Middle Aged Delivery Obstetric medicine.disease Pregnancy Complications Gestational diabetes Parity Apgar Score Intensive Care Neonatal Female business Maternal Age |
| Zdroj: | American Journal of Obstetrics and Gynecology. 175:668-674 |
| ISSN: | 0002-9378 |
| Popis: | OBJECTIVE: Our purpose was to describe the maternal and fetal outcomes of pregnancies in women ≥45 years old at delivery. STUDY DESIGN: A retrospective review of in-hospital deliveries after 20 weeks of gestation was performed in four Utah tertiary care hospitals for the 10-year period between 1985 and 1994. RESULTS: Seventy-nine cases were identified among 126,500 births, with an incidence of 0.63 per 1000 births. Maternal ages were 45 (n = 44), 46 (n = 21), and ≥47 (n = 14) years. Three of the conceptions were assisted, including both twin gestations. Thirty-seven (46.8%) had obstetric complications during pregnancy; the most frequent complications were gestational diabetes (12.7%) and preeclampsia (10.1%). Median (range) gestational age at delivery was 39 (22.9 to 41.7) weeks; 12 (15.2%) deliveries occurred before 37 weeks. Eight (9.9%) karyotype abnormalities were diagnosed. The cesarean section rate was 31.7%; the most frequent indications were abnormal lie (n = 9), fetal distress (n = 5), and previous cesarean delivery (n = 5). There were no maternal deaths. Median (range) birth weight was 3466 (397 to 5085) gm; 14 (17.3%) were 4000 gm. Twelve (14.8%) infants were admitted to the neonatal intensive care unit. The corrected perinatal mortality rate was 1.3% (1/78). CONCLUSIONS: In women >45 years old at delivery maternal and fetal outcomes were generally good, but there was a high incidence of pregestational (chronic hypertension, hypothyroidism) and gestational (karyotype abnormalities, gestational diabetes, cesarean section, macrosomia) complications. This information may be helpful for counseling women between 45 and 50 years old who are considering pregnancy. (Am J Obstet Gynecol 1996;175:668-74.) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect