Trends in advanced maternal age pregnancies in Brazil: a time-series study (2011-2021)

The aim of the study was to assess national trends in advanced maternal age pregnancies in Brazil between 2011 and 2021 and discuss their implications for maternal health care planning.

This ecological time-series study analyzed data from the Brazilian Live Birth Information System between 2011 and 2021. Births among women aged ≥35 years were identified, and temporal trends were evaluated using segmented regression models (joinpoint regression) to estimate Annual Percent Change and Average Annual Percent Change, both nationally and across the five Brazilian macro-regions.

A sustained increase in pregnancies among women of advanced maternal age was observed nationwide. From 2011 to 2019, the Annual Percent Change in Brazil was 5.3%, followed by a slower rise from 2019 to 2021 (Annual Percent Change=2.4%). The most pronounced growth was seen among women aged ≥45 years after 2016 (Annual Percent Change=6.4%). Regionally, the highest Average Annual Percent Changes were observed in the Central-West (5.5%), Northeast (5.2%), and North (5.0%), reflecting geographic variations in the pace and timing of this demographic shift. The overall Average Annual Percent Change for Brazil was 4.7%, confirming a consistent upward trend over the study period.

The rising prevalence of advanced maternal age in Brazil reflects broader demographic and social trends. Public health strategies must adapt to this reality, strengthening prenatal care and risk management protocols for older mothers.