Fetomaternal Outcome Among Antenatal Attendees With Advanced Maternal Age: A Cohort Study

Area of Science:

• Reproductive Health
• Maternal-Fetal Medicine
• Public Health

Background:

• Increasing prevalence of advanced maternal age (AMA) due to delayed childbearing.
• Existing evidence suggests AMA is associated with adverse maternal and fetal outcomes.
• Limited regional data from Oman regarding AMA and pregnancy outcomes.

Purpose of the Study:

• To evaluate the association between advanced maternal age (≥40 years) and pregnancy outcomes.
• To compare outcomes in women aged ≥40 years versus women <35 years in Oman.

Main Methods:

• Observational comparative cohort study conducted in Oman.
• 646 pregnant women enrolled: 323 aged ≥40 years (AMA group) and 323 aged <35 years (control group).
• Data collected on demographics, comorbidities, pregnancy complications, and fetal outcomes; statistical analysis using t-tests, chi-square, and logistic regression.

Main Results:

• AMA group showed significantly lower spontaneous vaginal delivery rates (16.1% vs. 46.1%) and higher preterm delivery rates (4.3% vs. 1.5%).
• Higher incidence of gestational diabetes (48.3% vs. 14.6%), hypertensive disorders (11.8% vs. 2.8%), and thyroid disorders (11.8% vs. 3.4%) in AMA women.
• Increased fetal complications in AMA group, including miscarriage (5.3% vs. 1.2%) and NICU admissions (3.4% vs. 0.9%). Logistic regression confirmed AMA as an independent predictor for several adverse outcomes.

Conclusions:

• Advanced maternal age is strongly associated with adverse maternal and fetal outcomes in the Omani population.
• AMA is an independent predictor for gestational diabetes, hypertensive disorders, cesarean delivery, miscarriage, NICU admission, and thyroid disorders.
• Highlights the need for targeted antenatal monitoring, early screening, and specialized counseling for high-risk pregnancies in women of advanced maternal age.