[Clinic characteristics of women with advanced maternal age and perinatal outcomes]

Objective: To explore the association between maternal age and perinatal outcomes. Methods: Totally, 3 151 women with advanced maternal age and 6 098 women younger than 35 years old who delivered in Beijing Obstetrics and Gynecology Hospital in 2016 were recruited. Their clinic characteristics and perinatal outcomes were collected to divide into 3 groups based on delivery age, Group 1 (aged 35-39 years, 2 683 cases), Group 2 (aged ≥40 years, 366 cases) and the control group (aged<35 years, 6 098 cases). The association between maternal age and adverse perinatal outcomes were analyzed, including hypertensive disorder complicating pregnancy, gestational diabetes mellitus (GDM), preterm birth and postpartum hemorrhage. Results: The rate of cesarean section history (27.39%, 33.61%, 5.53%) or previous myomectomy history (2.80%, 5.46%, 0.72%) were compared between the advanced maternal age groups and the control group, and the differences were statistically significant (P<0.05). The percentage of prepregnancy overweight and obesity (29.67%, 27.05%, 18.47%), complicated with myoma (14.83%,19.95%, 5.64%) were compared among the three groups, and the differences were statistically significant (P<0.05). The percentage of pregnancy through assisted reproductive technology (9.84%, 15.03%, 3.12%) also had statistically significant differences (P<0.05). The incidence of fetal chromosomal abnormalities (1.23%, 3.01%, 0.36%) and fetal malformations (1.94%, 4.37%, 0.48%) increased with the maternal age, with statistically significant differences (P<0.01). The mobidity of hypertensive disorders (9.84%, 13.11%, 9.23%), pregestational diabetes mellitus (1.83%, 2.19%, 0.72%), gestational diabetes mellitus (22.70%, 28.42%, 14.87%), premature rupture of membranes (25.57%, 19.40%, 31.42%), placenta previa (2.05%, 2.46%, 0.92%), preterm birth(8.35%, 11.20%, 5.51%), postpartum hemorrhage (25.11%, 18.31%, 20.27%) and forceps delivery (5.42%, 2.33%, 5.71%) were compared, and the differences were statistically significant (P<0.05). The cesarean section rate in primipara (45.42%, 75.74%, 21.33%) and multipara (51.46%, 61.54%, 30.95%) had statistically significant difference (P<0.05). The proportion of macrosomia (10.80%, 8.85%, 7.96%) and neonates transferred into neonatal ICU (9.63%, 11.48%, 5.21%) in term neonates had statistically significant difference (P<0.05). Conclusions: Women with advanced maternal age increase after new family planning policy put into effect, so do the risk of adverse perinatal outcomes. Attention and interventions should be made to cope with the occurrence of adverse perinatal outcomes.