Perinatal Outcomes of Women Aged 50 Years and Above

Pregnancies among women aged 40 and above are increasing in frequency. Nevertheless, little is known about the perinatal outcomes of women aged 50 years and above. The purpose of the study was to evaluate pregnancy outcomes in women at an extremely advanced maternal age of 50 years or above.

In a population-based cohort study, perinatal outcomes of women aged 50 years and above were compared with pregnancies in women according to maternal age. All singleton deliveries that occurred between the years 1991 and 2014 in a tertiary medical center were included. We excluded fetuses with congenital anomalies and chromosomal abnormality. Logistic regression models were used to control for confounders.

During the study period, 242,771 deliveries were included, of which 234,824 (96.7%) occurred in women aged < 40 years, 7,321 (3.0%) in women aged 40 to 44 years, 558 (0.2%) in women aged 45 to 49 years, and 68 (0.03%) in women aged 50 years and above. Maternal age of 50 years and above was noted as an independent risk factor for gestational diabetes mellitus (GDM), low Apgar scores, and cesarean delivery. Nevertheless, among pregnancies of women aged 50, pregnancy outcomes including GDM, preterm delivery, cesarean delivery, lower Apgar scores at 5 minutes (<7), and perinatal mortality were not significantly different than pregnancy outcomes of women aged 40 to 49 years.

Pregnancy at the maternal age of 50 years and older is independently associated with higher rates of GDM, cesarean delivery, and lower Apgar scores at 5 minutes; however, most perinatal complications were not higher compared with pregnant women aged 40 to 49 years. These findings suggest that while there is an increased risk of perinatal complications in pregnancies of women aged 40 years or above compared with younger women, there are no significant increased risks in women aged over 50 years.