Vacuum assisted delivery outcomes. Does advanced maternal age matter?

Abstract

This study evaluated whether advanced maternal age during vacuum-assisted delivery (VAD) leads to a higher rate of adverse maternal and neonatal outcomes. This retrospective cohort study included all nulliparous women who underwent a singleton, VAD in our institution, from 2014 through 2019. The women were grouped according to maternal age ≥ 35 in the study group and < 35 in the control group. Power analysis calculation determined that a sample size of at least 225 women in each group was sufficient to detect significant differences between groups in the rate of third- and fourth-degree perineal tears and umbilical cord pH < 7.15. primary maternal outcomes were third- and fourth-degree perineal tears. primary neonatal outcomes were umbilical cord pH < 7.15. Secondary outcomes were maternal blood loss, Apgar scores, cup detachment, and subgaleal hematoma. Outcomes were compared between the two groups. During the study period, 13,967 nulliparous women delivered in our institution, including 8,810 (63.1%) spontaneous vaginal deliveries, 2,432 (17.4%) instrumental deliveries and 2,725 (19.5%) cesarean sections. The rate of operative vaginal delivery was higher in the advanced maternal age group. Among the vaginal deliveries, 10,116 (90%) were to women < 35, with 2,067 (20.5%) successful vacuum-assisted delivery VAD, and 1,126 (10%) were to women ≥35 years, with 348 (30.9%) successful VAD. There were no significant differences in the rates of third and fourth-grade perineal lacerations or lower cord pH between the study groups. Although there was no difference in the indications for the procedure between the groups, advanced maternal age was associated with a higher head station during the pre-procedure assessment (p=0.002). Vacuum-assisted delivery is not associated with a higher risk for adverse maternal or neonatal outcomes among women with advanced maternal age.View Large Image Figure ViewerDownload Hi-res image Download (PPT)