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Advanced maternal age: perinatal outcome when controlling for physician selection
D C Lagrew1, M A Morgan, K Nakamoto
1Saddleback Memorial Medical Center, Women's Hospital, Laguna Hills, CA 92653, USA.
Summary
Advanced maternal age (40 years and older) is linked to increased pregnancy complications like cesarean delivery and hypertension, even when physician bias is controlled. Neonatal outcomes remained similar between age groups.
Area of Science:
- Maternal-fetal medicine
- Obstetrics
- Reproductive health
Background:
- Maternal age is a significant factor in pregnancy outcomes.
- Previous studies suggest increased risks for older mothers, but physician selection bias may confound results.
Purpose of the Study:
- To investigate if controlling for physician selection bias eliminates the association between advanced maternal age (>=40 years) and adverse maternal outcomes.
- To compare pregnancy outcomes between women aged >=40 and a younger control group (20-29 years).
Main Methods:
- A case-control study design was employed.
- 164 women aged >=40 were compared to controls (next two deliveries by the same physician, women aged 20-29).
- Retrospective analysis of antepartum and intrapartum records for clinical outcomes.
Main Results:
- Older mothers had significantly higher rates of nulliparous cesarean delivery, gestational glucose intolerance, and hypertension.
- Advanced maternal age was associated with increased use of assisted reproductive techniques, higher baseline, and maximum pregnancy weights.
- Neonatal and fetal outcomes were comparable between the groups despite maternal age differences.
Conclusions:
- Advanced maternal age is independently associated with increased risks of specific pregnancy complications, including cesarean delivery, glucose intolerance, and hypertension.
- These risks persist even after controlling for physician selection bias.
- Fetal and neonatal outcomes appear unaffected by advanced maternal age in this study.