Recurring Materno-fetal Complications in Late Pregnancy: An Integrative Review

Abstract

Background: Pregnancies at advanced ages are increasingly common in society, which represents a concern for the health system, since they are associated with complications and different comorbidities during pregnancy, which can negatively impact its course, due to the occurrence of adverse maternal-fetal events. Therefore, this study aims to summarize the main complications of advanced maternal age and their repercussions. Methods: An integrative review was developed, using the LILACS, MEDLINE, and PubMed databases and the search formula: (“complications”) AND (“pregnancy”) AND (“maternal age”), including articles in Portuguese, English, and Spanish from 2018 to 2023, excluding duplicates and review articles. Results: 484 articles were filtered and, after applying the inclusion and exclusion criteria, 28 articles were selected to compose the study. From them, a higher incidence of gestational diabetes mellitus was evidenced in mothers over 35 years of age due to the progressive depletion of pancreatic β-cell function. In addition, pre-eclampsia was found to be seven times more common in pregnant women aged 40 years than in those under 30 years of age, as the gastro-omental arteries reduce compliance, affecting blood pressure regulation. Conclusion: Therefore, advancing age is related to the emergence of metabolic alterations and cardiovascular diseases that can harm maternal and fetal health, since pregnant women over 35 years of age are more prone to comorbidities that can result in adverse maternal and neonatal outcomes.