Delayed motherhood: Birth outcomes at extremely advanced maternal age: A retrospective cohort study

This study aimed to evaluate and compare pregnancy and neonatal outcomes in women aged ≥ 45 years, categorized as having extremely advanced maternal age (EAMA), and a control group of women aged 25 to 35 years who delivered within the same time period. A retrospective cohort study was conducted at a tertiary referral center in Turkey, including 143 women aged ≥ 45 and 250 women aged 25 to 35 who gave birth between January 2017 and January 2024. Obstetric and neonatal outcomes were compared, including gestational age, mode of delivery, birthweight, Apgar scores, and neonatal intensive care unit (NICU) admissions. Cesarean delivery (71.3% vs 47.6%, P < .001), preterm birth (21.0% vs 9.2%, P = .001), and NICU admissions (21.7% vs 12.8%, P = .02) were significantly more frequent in the EAMA group. The median birthweight was also significantly lower in this group (3000 g vs 3305 g; P < .001), and extremely preterm births (<28 weeks) occurred only in the EAMA group. Women aged ≥ 45 years face significantly higher risks of adverse obstetric and neonatal outcomes, underscoring the need for tailored prenatal care and delivery planning in this growing patient population as delayed motherhood becomes increasingly prevalent.