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Age greater than thirty-four years is an independent pregnancy risk factor in nulliparous women
1Department of Obstetrics and Gynecology, St. John Hospital and Medical Center, Detroit, MI, USA.
Objective:
To compare quantitative pregnancy risk of nulliparous women 35 years and older with nulliparous women 25 to 29 years old.
Study Design:
Maternal records for first births at three suburban hospitals from July 1, 1986, to June 30, 1990, were studied, risk-assessed retrospectively according to a group-specific risk-scoring system, and compared statistically according to age and quantitative pregnancy risk.
Results:
The older women were more likely to be high risk (score > or = 10) prepregnancy (odds ratio [OR] 2.9, 95% confidence interval [CI] 1.9 to 4.5), antepartum (OR 1.6, 95% CI 1.3 to 2.0), intrapartum (OR 2.2, 95% CI 1.8 to 2.6), and cumulatively (OR 2.6, 95% CI 2.2 to 3.2) when compared with younger women. They were also more likely to be very high risk (score > or = 20) antepartum (OR 1.8, 95% CI 1.1 to 2.9), intrapartum (OR 2.1, 95% CI 1.5 to 2.8), and cumulatively (OR 2.5, 95% CI 2.0 to 3.2). Risk increased progressively through pregnancy, revealing the intrapartum period as the time interval of maximum risk. Based on cumulative risk scoring, 64.9% of the older women were at least high risk, compared with 41.3% of the younger women (OR 2.6, 95% CI 2.2 to 3.2).
Conclusion:
Nulliparous women 35 years and older from a predominantly middle-class, white population had a significantly higher quantifiable pregnancy risk than a similar group of women age 25 to 29, suggesting that age greater than 34 years is an independent pregnancy risk factor.