Abstract
We aimed to determine the association between maternal age and pregnancy outcomes in singleton primigravidae in South Korea. We reviewed the medical data of singleton primigravidae women who gave birth between 2013 and 2018 and underwent the National Health Screening Examination using the administrative database from the National Health Insurance claims data. As advanced maternal age is associated with various comorbidities that could affect pregnancy outcomes, we divided the patients according to their age and comparatively analyzed the prevalence of high-risk pregnancy complications including rates of cesarean delivery, after adjusting for maternal demographics. Perinatal and postpartum complications according to maternal age were also investigated. Overall, 548,080 women were included in this study: 441,902 were aged <35 years; 85,663, 35–39 years; 20,515, ≥40 years. Patients’ demographics differed according to their age. Increasing maternal age was significantly associated with higher income levels and higher rates of obesity, pre-existing diabetes, and hypertension. With the increasing maternal age, the rate of obstetric complications, including gestational diabetes, preeclampsia, placenta previa, placental abruption, and cesarean delivery, increased. Maternal age was also positively correlated with perinatal morbidity including preterm birth and low birth weight. Additionally, advanced maternal age was a risk factor for hospitalization before delivery, more frequent outpatient visits, and readmission after delivery. These observations were maintained in the multivariate analysis results. Advanced maternal age appears to be associated with various adverse obstetric outcomes for primigravidae women, and the frequency of hospitalizations was higher in this group. Considering the current social environment of late pregnancies and childbirth in South Korea, effective policy consideration is required to support safe childbirth in women with advanced maternal age.
Highlights
This study evaluated the overall pre-pregnancy risk factors for adverse pregnancy complications in women of AMA and sought to determine the impact of maternal age on pregnancy outcomes in singleton primigravidae in
This study showed that AMA could be a risk factor for various types of adverse pregnancy outcomes, perinatal morbidity, and postpartum complications in South Korea
Most adverse pregnancy outcomes including gestational diabetes mellitus (GDM) requiring insulin treatment, preeclampsia requiring magnesium sulfate administration, placenta previa, placental abruption, cesarean section, preterm birth, low birth weight (LBW), and postpartum hemorrhage were more frequently observed in women aged ≥35 years compared to those aged
Summary
Advanced maternal age (AMA) is defined as an age ≥35 years on the estimated date of delivery. There is a notable trend towards increasing maternal age at childbirth worldwide, in developed countries. Data from The Organization for Economic Cooperation and Development revealed that most women in developed countries currently have their first birth at ≥30 years of age; this age has risen by approximately 5 years over the last two decades globally [1]. In the United States, 9% of all the first births in 2014 were to mothers of AMA, and this represented a 23% increase from 2000 [2]. The mean age at first birth in the United States has increased by approximately 5 years
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