Reproducción en pacientes de más de 40 años: estudio multicéntrico de los resultados obstétricos de 2.578 partos

Abstract

IntroductionAdvanced age reproduction has become a social reality associated to medical complications. Material and methodsData were collected from 2578 women, all over 40 years-old, who gave birth in 9 public hospitals in Spain between 2015 and 2016. Data from those pregnancies, as well as those from Spanish National Registry, were used to evaluate the pregnancy and the obstetrics outcomes. ResultsUp to 33.3% of the pregnancies analysed were from using assisted reproduction techniques, and according to the National Registry, 79.5% of them were obtained by egg donation. The incidence of positive aneuploidy screening was 7.8%, with a malformation rate of 5.07%. Gestational diabetes was also detected in 13.98%. Hypertensive events occurred in 5.37%, and 2.87% cases were diagnosed with intra-uterine foetal growth retardation. As regards the newborns, 18.9% weighed less than 2500 g, and 2.63% less than 1500 g. There were 15.5% preterm deliveries, with 12.32% between 32 and 37 weeks, 2.08% between 28 and 32 weeks, and 0.7% less than 28 weeks. The incidence of intra-uterine foetal death was 0.48%. A total of 33.09% caesarean sections were performed. An unfavourable Apgar Score (<7) was observed in 13.75% of the newborns, and maternal pospartum complications appeared in 7.86% of the cases. There were 5.59% twin pregnancies in the women in the study. ConclusionsThe analysis of these perinatal results confirms that advanced age pregnancy is a risk situation. There is a need of an adequate counselling before using assisted reproduction techniques, and specific obstetrics care follow-up seems unquestionable.