Maternal age and severe maternal morbidity: A population-based retrospective cohort study

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Public Health

Background:

• Maternal mortality reduction goals remain unmet in industrialized nations.
• Rising average maternal age correlates with understudied severe maternal morbidity.
• Severe maternal morbidity and adverse fetal/infant outcomes require further investigation in relation to maternal age.

Purpose of the Study:

• To examine associations between maternal age and severe maternal morbidities.
• To compare these associations with those for adverse fetal/infant outcomes.

Main Methods:

• Population-based retrospective cohort study of singleton births in Washington State (2003-2013).
• Comparison of age-specific rates of maternal mortality/severe morbidity and fetal/infant outcomes.
• Logistic regression analysis adjusted for confounders (parity, BMI, etc.).

Main Results:

• Severe maternal morbidity increased with maternal age, particularly for women aged ≥40.
• Older mothers (≥40) showed elevated risks for renal failure, obstetric shock, and ICU admission.
• Teen mothers had higher risk of maternal sepsis and neonatal mortality, while older mothers faced increased stillbirth risk.

Conclusions:

• Older maternal age (≥40) is linked to significantly higher rates of severe, potentially life-threatening maternal morbidities.
• Findings underscore the need for improved counseling for women delaying childbirth and enhanced preventive strategies.
• Maternal age-specific severe morbidity rates vary by outcome, necessitating tailored approaches to maternal care.