Advanced Maternal Age and Incidence of Non-Chromosomal Congenital Anomalies: A Population-based Study [35Q

Abstract

INTRODUCTION: Advanced maternal age (AMA), is associated with an increased risk of aneuploidy, adverse pregnancy outcomes, and infertility. Our study's objective is to assess whether AMA increases the risk of non-chromosomal congenital anomalies. METHODS: A retrospective cohort study was conducted using a linked dataset from Alberta Perinatal Health Program and the Alberta Congenital Anomalies Surveillance System databases. All singleton births and pregnancy terminations greater than 20 weeks gestational age from 2005 to 2013 were included. Pregnancies with aneuploidy were excluded. Maternal age was categorized as less than 35 years and 35 years and greater. Descriptive statistics of maternal demographic characteristics were generated. Multinomial logistic regression models controlled for parity, use of assisted reproductive technology, smoking, and socioeconomic status. RESULTS: There is a significant association between AMA and congenital anomalies in the kidney (P=.004), and reproductive tract (P=.021). The rate of anomalies in the kidney was 2.6 per 1,000 births for women under 20 and rose to 3.0 per 1,000 births for women 35 and older. The rate of anomalies in the reproductive tract was 3.5 per 1,000 births in women under 20, and rose to 4.6 per 1,000 births in women 35 and up. Analysis of the type of anomaly revealed a significant association between AMA and congenital obstructive defects of the renal pelvis (P=.025), other malformations of the kidney (P < .001), undescended testicle (P=.032), congenital deformities of the hip (P < .001) and congenital deformities of the feet (P=.001). CONCLUSION: Advanced Maternal Age appears to be associated with an increased incidence of specific non-chromosomal congenital anomalies, particularly of the renal and genitourinary systems.