Vacuum-assisted delivery outcomes: is advanced maternal age a factor?

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Vacuum-assisted vaginal delivery (VAD) is an obstetric procedure used to assist childbirth.
• Maternal age is an increasing factor in pregnancy, with advanced maternal age (≥35 years) potentially associated with different delivery outcomes.

Purpose of the Study:

• To evaluate the association between advanced maternal age and maternal outcomes in vacuum-assisted vaginal deliveries (VAD).
• To compare adverse maternal and neonatal outcomes between nulliparous women aged ≥35 years and those <35 years undergoing VAD.

Main Methods:

• Retrospective cohort study of nulliparous women undergoing singleton VAD at an academic institution.
• Maternal age groups: ≥35 years (study group) and <35 years (controls).
• Primary outcomes: third- and fourth-degree perineal tears and umbilical cord pH < 7.15. Secondary outcomes included maternal blood loss, Apgar scores, cup detachment, and subgaleal hematoma.

Main Results:

• Women aged ≥35 years were more likely to undergo VAD (30.9%) compared to women <35 years (20.5%).
• No significant difference in rates of third- and fourth-degree perineal lacerations between advanced maternal age (1.7%) and control groups (2.8%).
• Umbilical cord pH < 7.15 was similar between groups (6.6% vs. 7.5%).

Conclusions:

• Advanced maternal age is not associated with an increased risk of adverse maternal or neonatal outcomes following vacuum-assisted vaginal delivery.
• Older, nulliparous women demonstrate a higher likelihood of undergoing vacuum-assisted vaginal delivery compared to their younger counterparts.