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Outcomes of multiple gestations with advanced maternal age
Nathan S Fox1, Andrei Rebarber, Samantha M Dunham
1Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York, USA. nfox@mfmnyc.com
Summary
Advanced maternal age (AMA) in twin pregnancies is not linked to adverse outcomes, except for a higher Cesarean delivery rate. This study compared AMA and non-AMA groups in twin gestations.
Area of Science:
- Maternal-Fetal Medicine
- Reproductive Health
- Obstetrics
Background:
- Advanced maternal age (AMA), defined as 35 years or older, is increasingly common in twin gestations.
- The impact of AMA on twin pregnancy outcomes requires further investigation.
Purpose of the Study:
- To investigate pregnancy outcomes in twin gestations with advanced maternal age (AMA).
Main Methods:
- A historical cohort study compared outcomes of twin gestations in patients with AMA (n=70) and non-AMA (n=75).
- Analysis included mode of delivery, gestational age at delivery, and overall complications.
- Statistical significance was determined using chi-square or Student's t-tests.
Main Results:
- The Cesarean delivery rate was significantly higher in the AMA group (80.0%) compared to the non-AMA group (54.7%; p=0.001), primarily due to uterine dysfunction.
- Mean gestational age at delivery was significantly greater for AMA (36.7 weeks) versus non-AMA (35.4 weeks; p=0.02).
- No significant differences were observed in rates of gestational hypertension, pre-eclampsia, gestational diabetes, fetal growth restriction, preterm birth, or low birth weight.
Conclusions:
- Advanced maternal age in twin pregnancies is not associated with an increased risk of adverse pregnancy outcomes.
- The primary difference observed was a higher rate of Cesarean delivery in women with advanced maternal age.
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