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El retraso en el parto y el riesgo de resultados perinatales adversos. Un estudio basado en la población
S Cnattingius1, M R Forman, H W Berendes
1Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892.
JAMA
|August 19, 1992
Resumen
El retraso en el parto aumenta los riesgos de resultados adversos del embarazo, incluida la muerte fetal y el bajo peso al nacer, incluso en mujeres sanas. Este estudio pone de relieve la importancia de considerar la edad materna en la atención prenatal.
Área de la Ciencia:
- Salud reproductiva y salud reproductiva.
- La epidemiología perinatal.
- La medicina materno-fetal es una de ellas.
Sus antecedentes:
- El avance de la edad materna es una tendencia creciente a nivel mundial.
- El impacto de la edad materna en los resultados del embarazo requiere una investigación continua, particularmente en mujeres nulíparas sanas.
- Es posible que los estudios anteriores no se hayan ajustado por completo a los factores de confusión.
Objetivo del estudio:
- Examinar la asociación entre la edad materna avanzada y los resultados del embarazo.
- Para evaluar específicamente los riesgos en madres primerizas sanas.
- Para controlar los factores de confusión demográficos, de estilo de vida y médicos.
Principales métodos:
- Estudio de cohorte basado en la población utilizando datos recolectados prospectivamente del Registro Médico Sueco de Nacimiento.
- Incluidas 173.715 mujeres nórdicas núliparas de 20 años o más, que dieron a luz singletons entre 1983-1987.
- Las tasas analizadas de muerte fetal tardía, peso al nacer muy bajo (VLBW), peso al nacer moderadamente bajo (MLBW), nacimiento muy prematuro, nacimiento moderadamente prematuro y bebés pequeños para la edad gestacional (SGA).
Principales resultados:
- Las mujeres de 30 a 34 años mostraron mayores probabilidades de muerte fetal tardía, VLBW, MLBW, nacimiento muy prematuro y bebés SGA en comparación con las de 20 a 24 años.
- Los riesgos de VLBW, MLBW, parto muy prematuro, parto moderadamente prematuro y bebés SGA fueron significativamente más altos para las mujeres de 35 a 39 y 40 años o más.
- La edad materna avanzada se correlacionó con elevadas tasas de probabilidades en múltiples resultados perinatales adversos.
Conclusiones:
- El retraso en el parto está relacionado con una mayor incidencia de resultados adversos del embarazo.
- Estos riesgos persisten incluso después de tener en cuenta las complicaciones maternas y otros factores de riesgo establecidos.
- Los hallazgos subrayan la necesidad de estrategias de atención prenatal a medida para las madres mayores.
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