Early singleton pregnancy outcome: effects of maternal age and mode of conception.

Abstract

To assess the effect of prognostic factors on the outcome of singleton pregnancies. First-trimester ultrasonographic (US) scans that demonstrated a living fetus in 4,156 consecutive singleton pregnancies were studied. The relationship between outcome and maternal age, mode of conception, maternal symptoms, and US findings was evaluated. Spontaneous abortion occurred in 371 of 4,156 (8.9%) cases. Higher pregnancy-loss rates were associated with older maternal age (P < 10(-5)), assisted mode of conception (P < 10(-8)), maternal symptoms of pain and/or bleeding (P < .001), and abnormal US findings (P < 10(-8)). US abnormalities were more frequent in older women than in younger women (P < 10(-5)) and in assisted conceptions than in natural conceptions (P < 10(-8)). At stepwise logistic regression, with gestational age as a covariate, US abnormalities and maternal symptoms independently affected pregnancy outcome. Maternal age and mode of conception had no further statistically significant effect on pregnancy outcome. The prognosis for older mothers and for those with assisted conception is not statistically significantly different from that for younger mothers and for those with natural conception if maternal symptoms, US findings, and gestational age are the same.