Maternal age and pregnancy outcomes in twin compared with singleton gestations
Liran Hiersch1,2, Howard Berger3, Sarah D McDonald4
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
Summary
Advanced maternal age is linked to higher preterm birth risks in singleton pregnancies. However, this association is not significant in twin pregnancies, despite their higher complication rates.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Epidemiology
- Maternal-Fetal Medicine
Background:
- Advanced maternal age (AMA) is associated with increased pregnancy complications.
- Twin pregnancies inherently carry higher risks of adverse outcomes compared to singleton pregnancies.
Purpose of the Study:
- To investigate the association between advanced maternal age and pregnancy complications in twin gestations.
- To compare this association with that observed in singleton pregnancies.
Main Methods:
- A population-based retrospective cohort study analyzed hospital birth data in Ontario, Canada (2012-2019).
- Included singleton and twin pregnancies, with preterm birth (PTB) < 34 weeks as the primary outcome.
- Outcomes were stratified by maternal age groups for both pregnancy types.
Main Results:
- In singleton pregnancies, PTB risk increased with maternal age, peaking at ≥45 years (3.4%).
- In twin pregnancies, PTB rates were highest in those under 20 (25.3%) and lowest in the 35-39 age group (11.7%).
- The association between maternal age and PTB risk was not statistically significant in twin pregnancies after adjustment.
Conclusions:
- While absolute complication rates are higher in twin pregnancies, the relationship between maternal age and specific risks differs significantly between twin and singleton gestations.
- This highlights distinct age-related risk profiles for pregnancy complications in multifetal versus singleton gestations.
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