Advanced Maternal Age Associated With Significantly Increased Cervical Ripening Times and Decreased Vaginal Delivery Rates [ID: 1367634

Abstract

INTRODUCTION: With increasing numbers of advanced maternal age (AMA) gravidas, labor characteristics specific to this population are important to understand. The objective of this study was to examine patterns in cervical ripening times and vaginal delivery rates for patients with AMA. METHODS: This was an IRB-approved retrospective cohort study conducted at a single academic center. Data were collected by retrospective chart review of deliveries from 2020 to 2021. We included nulliparous patients aged 18 or older with singleton pregnancies, pre-pregnancy body mass index of 18.5 or greater, and gestational age of 37.0 or greater. Patients with pregestational diabetes and lethal fetal anomalies were excluded. RESULTS: One thousand twenty-two patients met inclusion and exclusion criteria, 17.7% of whom were AMA. Lower gestational age and less Hispanic ethnicity were noted in the AMA group. Among AMA patients, there was an increase in cervical ripening time as compared to patients aged older than 35 with an average difference of 3.14 hours (CI 1.26–5.01, P=.001). Compared to participants younger than 35, those that are AMA were 36% less likely to have a vaginal delivery (CI 0.46–0.89, P=.008). Median cervical ripening time to vaginal delivery was 15.0 hours for non-AMA and 19.9 hours for AMA patients. At any point of cervical dilation, AMA patients had a 28% less chance to have a vaginal delivery than non-AMA (P<.001). CONCLUSION: Patients who were AMA experienced increased cervical ripening times and decreased rates of vaginal deliveries compared to patients younger than 35. Knowing labor characteristics specific to the AMA population is important for counseling and clinical decision-making.