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Maternal age and risk for adverse outcomes
Jean-Ju Sheen1, Jason D Wright1, Dena Goffman1
1Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY.
American Journal of Obstetrics and Gynecology
|August 29, 2018
Summary
Maternal age significantly impacts pregnancy risks. Women aged 45 and older face the highest risk for severe maternal morbidity and complications, highlighting the need for age-specific care during delivery hospitalizations.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Public Health
Background:
- Maternal age is a known factor influencing pregnancy outcomes.
- Advanced maternal age (typically 35+) is associated with increased risks.
- Adolescent pregnancy also carries specific risks.
Purpose of the Study:
- To analyze the relationship between maternal age and severe maternal morbidity.
- To characterize risks for various pregnancy complications across different maternal age groups.
- To provide national estimates of adverse maternal outcomes by age.
Main Methods:
- Retrospective cohort analysis of the Perspective database (2006-2015).
- Categorization of women into 7 age groups (15-17 to 45-54 years).
- Analysis of severe maternal morbidity, comorbid conditions, and specific pregnancy complications using adjusted risk ratios (aRRs).
Main Results:
- Over 36.9 million deliveries were analyzed.
- Women aged 45-54 had the highest risk for severe morbidity (aRR, 3.46) and complications like preeclampsia and postpartum hemorrhage.
- Increased risks were also observed in younger (15-17 years) and older (40-44 years) age groups compared to the 25-29 reference group.
Conclusions:
- Maternal age is a critical determinant of severe maternal morbidity and adverse pregnancy outcomes.
- Women aged 45 and older experience disproportionately higher risks across a spectrum of complications.
- Age-specific risk stratification is essential for optimizing maternal care and delivery outcomes.
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