Very Advanced Maternal Age and Obstetric Outcomes [40L

Abstract

INTRODUCTION: Mean maternal age continues to increase in the United States and more women are getting pregnant in their forties or older. We aimed to examine the risk of adverse obstetric outcomes in a diverse contemporary urban population of women of very advanced maternal age, defined as age 40 years or older at estimated date of delivery (EDD). METHODS: This retrospective cohort study examined patients presenting for delivery in an urban Midwest academic healthcare system from 2016 to 2017. Women 40 years of age or older at EDD (n=433) were compared with controls between age 25 to 30 years at EDD (n=755), in relation to risk of adverse obstetric outcomes. Chi-square and Fisher exact tests were used to evaluate categorical variables. RESULTS: Women 40 years or older were more likely to experience adverse obstetric outcomes, including an increased risk of gestational diabetes, gestational hypertension, amniotic fluid abnormalities, fetal growth restriction, PPROM, preterm labor and pre-delivery hospitalization (all P<.05). No difference in the identification of prenatal fetal anomalies was seen between the two groups. CONCLUSION: Very advanced maternal age (≥40 years at EDD) is associated with an increased risk of adverse obstetric complications. These data will help guide management and counseling of women contemplating or achieving pregnancy at more advanced maternal age.