Pregnancy outcome at extremely advanced maternal age

Area of Science:

• Reproductive Medicine
• Maternal-Fetal Medicine
• Obstetrics

Background:

• Advanced maternal age (≥ 45 years) presents unique challenges in pregnancy.
• Understanding pregnancy outcomes in this demographic is crucial for clinical management and patient counseling.

Purpose of the Study:

• To evaluate pregnancy outcomes in women at extremely advanced maternal age (≥ 45 years).

Main Methods:

• A comparative study involving 177 women aged ≥ 45 years.
• Matched comparison with younger age groups (20-29, 30-39, 40-44 years) in a 1:10 ratio.
• Subgroup analysis comparing women aged 45-49 with those aged ≥ 50 years.

Main Results:

• Women aged ≥ 45 experienced significantly higher rates of gestational diabetes mellitus (17.0% vs 5.6%) and hypertensive complications (19.7% vs 4.5%).
• Increased odds of preterm delivery (<37 and <34 weeks), cesarean delivery (OR 31.8), placenta previa, postpartum hemorrhage, and adverse neonatal outcomes were observed.
• Women aged ≥ 50 faced elevated risks for gestational diabetes, preeclampsia, preterm delivery, and NICU admission.

Conclusions:

• Pregnancy at extremely advanced maternal age (≥ 45 years) is associated with substantially increased maternal and fetal risks.
• These findings underscore the need for heightened surveillance and specialized care for older pregnant individuals.