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Delayed childbearing--are there any risks?

C L Roberts1, C S Algert, L M March

  • 1Northern Sydney Area Public Health Unit, Hornsby Ku-ring-gai Hospital, NSW.

The Medical Journal of Australia
|May 2, 1994
PubMed
Summary
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Women aged 35 and older delivering their first child face increased risks of hypertension and preterm labor. However, most adverse pregnancy outcomes are manageable with current obstetric care.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Epidemiology

Background:

  • Advanced maternal age (35+ years) is increasingly common for first-time mothers.
  • Understanding the specific risks associated with delayed childbearing is crucial for prenatal care.

Purpose of the Study:

  • To investigate the association between advanced maternal age at first birth and adverse, non-genetic pregnancy outcomes.
  • To identify specific risks for women delivering their first child at age 35 years or older.

Main Methods:

  • Cross-sectional analytic study conducted in Northern Sydney Area Health Service hospitals.
  • Included singleton deliveries from women aged 20 years and older for their first child between 1990-1991.
  • Analyzed obstetric complications, delivery procedures, and neonatal outcomes.

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Main Results:

  • Women aged 35+ had higher risks of pre-existing maternal hypertension (aOR 3.5), antepartum hemorrhage (aOR 2.4), preterm delivery (33-36 weeks, aOR 2.0), and breech presentation (aOR 1.8).
  • Older mothers were more likely to undergo operative delivery, labor induction, and epidural anesthesia.
  • No increased risk was observed for pregnancy-induced hypertension, gestational diabetes, very preterm delivery, perinatal death, or low Apgar scores.

Conclusions:

  • Delaying first childbirth to age 35+ is associated with certain increased obstetric risks.
  • These identified risks are largely manageable within contemporary obstetric practice.
  • This highlights the importance of tailored care for older primiparous women.