Abstract
Background:In Japan, the proportion of women aged 35 and older giving birth has greatly increased in recent years, and maternal age is continuing to increase. Advanced maternal age is a risk factor for abnormal delivery, as is hiesho (sensitivity to cold).Research Question: This study aimed to assess whether advanced maternal age and hiesho precipitate premature delivery, premature rupture of membranes, weak labor pains, prolonged labor and atonic bleeding.Method: The study design was a descriptive comparative study with a retrospective cohort group design. Subjects in this study were 2,810 Japanese women in hospital after childbirth. The research methods employed were a paper questionnaire and extraction of data from medical records.Results:Comparing the rate of occurrence of abnormal delivery among women aged 35 to 39 according to whether or not they had hiesho, results were premature delivery OR: 3.51 (95% CI: 1.66-7.43), premature rupture of membranes OR: 1.25 (95% CI: 0.90-1.74), weak labor pains OR: 2.94 (95% CI: 1.65-5.24), prolonged labor OR: 2.56 (95% CI: 1.23-5.26), and atonic bleeding, OR: 1.65 (95% CI: 0.14-2.40) when hiesho was present. Among women aged 40 and over, results were premature delivery OR: 5.09 (95% CI: 1.16-22.20), premature rupture of membranes OR: 1.60 (95% CI: 0.73-3.46), weak labor pains OR: 7.02 (95% CI: 1.56-31.55), prolonged labor OR:7.19 (95% CI: 1.49-34.60) and atonic bleeding OR: 2.00 (95% CI: 0.64-6.23).Conclusions: Regardless of maternal age, the presence of hiesho is a risk factor that can precipitate premature delivery, premature rupture of membranes, weak labor pains, prolonged labor and atonic bleeding. Furthermore, hiesho coupled with advanced maternal age increases the incidence of premature delivery, weak labor pains and prolonged labor.
Highlights
Demographic change—population aging and a declining birthrate— is continuing unabated in Japan
Among women aged 40 and over, results were premature delivery Odds Ratio (OR): 5.09, premature rupture of membranes OR: 1.60, weak labor pains OR: 7.02, prolonged labor OR:7.19 and atonic bleeding OR: 2.00
Hiesho coupled with advanced maternal age increases the incidence of premature delivery, weak labor pains and prolonged labor
Summary
Demographic change—population aging and a declining birthrate— is continuing unabated in Japan. It is widely known that there are increased risks in childbirth at an advanced maternal age, and in perinatal health care, the Japan Society of Obstetrics and Gynecology defines childbirth by primipara aged 35 and over as first childbirth at an advanced maternal age and states that first births at an advanced maternal age are a risk factor at the time of delivery. Guidelines for perinatal health care for 2010 call for careful management of first births at an advanced maternal age [1]. In Japan, the proportion of women aged 35 and older giving birth has greatly increased in recent years, and maternal age is continuing to increase. Advanced maternal age is a risk factor for abnormal delivery, as is hiesho (sensitivity to cold). Research Question: This study aimed to assess whether advanced maternal age and hiesho precipitate premature delivery, premature rupture of membranes, weak labor pains, prolonged labor and atonic bleeding. 595 women under the age of 35 (33.4%), 413 women aged 35 to 39 (47.5%), and 90 women aged 40 and over (57.3%) developed complications; the higher the age of the women, the higher the ratio of occurrence of complications
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