Advanced Maternal Age Mothers Research Articles

The association between serum uric acid and low birth weight in advance maternal age women with hypertension: An observational study.

In China, the implementation of 2-child policy since 2015 entitles increasing number of advanced maternal age. Recently, Chinese hypertensive disorders of pregnancy (HDP) in advanced-age women have attracted significant clinical and epidemiological research interest. Previous studies have shown an association between serum uric acid (SUA) levels and low birth weight (LBW) in children. Several studies have reported that advanced maternal age is a risk factor for many complications in pregnancy, including LBW. However, it remains unclear whether SUA affects LBW risk in advanced maternal age mothers with hypertensive diseases. The study was observational in nature. A total of 692 advanced maternal age with hypertension were enrolled in our study. A variety of demographic and vital sign data, laboratory test results, and pregnancy outcomes were collected. Children born with LBW served as the clinical endpoint. On admission, blood samples were taken, and women with advanced maternal ages were divided into 2 groups based on their SUA levels. In order to investigate the association between SUA and LBW, a logistic regression model was used. E-value analysis was used to determine the residual unmeasured confounding. The mean SUA level was increased in advanced maternal age patients with HDP. Of 692 newborns, 244 (35.26%) have LBW. With possible confounders adjusted, high SUA levels were independent risk factors for LBW (odds ratio [OR]2.88, 95% confidence intervals [CI]1.22-6.81), multivariate logistic regression analysis using SUA as a continuous variable recapitulated the pattern (OR 1.01, 95% CI 1.00-1.01). In addition, SUA levels in women with advanced maternal age and hypertension were linearly related to LBW incidence. According to this study, SUA levels in patients with advanced maternal age and HDP are associated with LBW incidence.

Short-Term Outcomes of Singleton Newborns Born to Very Advanced Age Mothers—A Case Control Study in a Single Maternity and Neonatal Center in Israel

Background: Increasing rates of very advanced maternal age (VAMA, 45 years of age and older) are reported worldwide. Data are available on maternal pregnancy-related morbidity, but they are lacking on the infants’ overall post-partum well-being, including congenital malformations, neonatal complications, and breastfeeding status. Methods: We conducted a retrospective review during the period of 7 years (January 2013 to December 2019). Clinical data recorded in the medical files of 626 VAMA mothers and their singleton newborns in comparison to matched controls comprised advanced maternal age (AMA) mothers and mothers between 20 and 35 years of age. Univariate and multivariate analysis of the data was performed. Results: The infants were significantly less exclusively breastfed during hospitalization (17.4% vs 33.9% and 32.1%, respectively, P <.001). The rate of early transient hypoglycemia was also significantly higher among the newborns of VAMA mothers compared to the AMA and younger-aged mothers (14.7% vs 11.8% and 7%, respectively, P <.001), as was special care unit hospitalization (18.7% vs 15.5% and 13.3%, respectively, P =.03). There was no difference in any other analyzed parameters. Conclusions: Newborns of VAMA mothers are less likely to be exclusively breastfed during hospitalization. They do not exhibit significantly increased major neonatal morbidities, but are more likely to sustain hypoglycemia and neonatal caregivers should be alert to the possibility of newborn early transient hypoglycemia. In an era of growing evidence of the beneficial impact of breast milk on development and immunization, VAMA mothers should be guided and encouraged to breastfed their newborns.

The Biomedical Subjectification of Women of Advanced Maternal Age: Reproductive Risk, Privilege, and the Illusion of Control.

The United States is experiencing a demographic transition toward older motherhood. Biomedicine classifies pregnancies among all women of advanced maternal age (AMA) as high-risk; paradoxically, women having first births at AMA are typically economically and racially privileged, which can reduce the risk of risks. This article examines the implications of the biomedicalization of AMA for first-time mothers, age 35 and older, using qualitative interviews. We find participants had substantial cultural health capital, which informed their critiques of AMA and the medical model of birth. When they found themselves subjected to biomedical protocols and concerned about reproductive risk as their pregnancies progressed, their subsequent biomedical subjectification compelled most to accept biomedical interventions. Consequently, some participants had traumatic birth experiences. Our findings illustrate that while first-time mothers of AMA anticipated that they would have more control over the birth process because of their advantages, ultimately, most did not.

Pregnancy outcomes at advanced maternal age in a tertiary Hospital, Jeddah, Saudi Arabia.

Objectives:To evaluate obstetrical and fetal outcomes among advanced maternal age (AMA) women.Methods:Retrospective cohort study carried out at a teaching hospital, Jeddah, Saudi Arabia, during 18 years period (from January 2003 until December 2020). A total of 79095 women gave birth, and randomized block was used to include 4318 singleton pregnancy women (>28 gestational weeks), of them 2162 age ≥40 years. Associations between AMA and obstetrical and fetal parameters were assessed.Results:Advanced maternal age independently associated with non-Saudi national, mother’s weights 80-99 kg, diabetes mellitus, and hypertension. Advanced maternal age mothers were more liable to premature rupture of membranes (PROM), caesarean (CS) deliveries, and postpartum hemorrhage. Newborn of AMA women were at high risk of birth weight <2500 g, birth weight 3600-4500 g, decline Apgar score at 5 minutes, and neonatal intensive care unit (NICU) admissions.Conclusion:Advanced maternal age is an independent risk factor for adverse obstetric hazards as CS, antepartum haemorrhage, diabetes mellitus, hypertension, PROM, postpartum hemmorage, and fetal complications as low birth weight, macrosomia, NICU admission, congenital anomalies, and low Apgar score. These results must be carefully considered by maternal care providers to effectively improve clinical surveillance.

Maternal advanced age, single parenthood, and ART increase the risk of child morbidity up to five years of age

BackgroundAdvanced maternal age, single status and use of assisted reproductive technology (ART) are increasing in mothers in high-income countries, and all are known risk factors for negative obstetric outcomes. Less is known about their long-term consequences for childhood morbidity. Thus, the aim of this study was to investigate morbidity up to five years of age, in the children of older, single, and/or ART-treated mothers.MethodsA cross-sectional using Swedish registers was performed comprising 23 772 children. The prevalence of diagnosis and the number of hospital visits for specialist care, were compared and analyzed in relation to maternal age at childbirth, maternal civil status, and mode of conception. The odds ratio for specialized care within each ICD-chapter were estimated using single and multiple logistic regression.ResultsChildren born to single mothers and children conceived using ART had significantly more outpatient visits for specialist care and significantly more diagnoses compared to children with married/cohabiting mothers, and spontaneously conceived children. Children born to mothers of advanced maternal age (≥40) had fewer in- and outpatient visits. However, they were significantly more often diagnosed within ICD-chapters XVI, XVII i.e., they experienced more morbidity in the neonatal period.ConclusionThe results indicate that children born to single mothers and children of ART-treated mothers have a higher morbidity and consume more specialist care than children of married/cohabiting and spontaneously pregnant mothers. We conclude that the use of ART, maternal single status and advanced maternal age are risk factors of importance to consider in pediatric care and when counseling women who are considering ART treatment.

The effect of adolescent and advanced-age pregnancies on maternal and early neonatal clinical data

Background This study compared early post-natal clinical data of adolescent and advanced maternal-age mothers and their infants and early post-natal clinical data of mothers 20–34 years old who delivered and their infants. Methods This retrospective study included 1676 newborns who were born at or after 25 gestational weeks and 1638 puerperal women who gave birth at the Health Sciences University Bakırköy Dr. Sadi Konuk Health Practice and Research Center Gynecology and Obstetrics Clinic between January 2017 and January 2018. Maternal demographic and clinical data and neonatal demographic, anthropometric, and early delivery room clinical data of the study group patients were transcribed from clinical file records to electronic records. Results We found that the intensive care admission/2nd- or 3rd-level intensive care referral rates of newborns of advanced-age and adolescent mothers were significantly higher than those of the control group. No significant differences were found between intensive care admission and referral rates among age groups when only healthy pregnancies were considered. Cesarean sections, abortion and smoking rates of mothers with advanced maternal age; LGA rates of newborns of women in this age group; macrosomic rates; and free-flow oxygen requirements were significantly higher than in the other age groups. In advanced-age healthy pregnancies, abortion rates were the same as those in the control group, and there was no significant difference in the LGA rate or free-flow oxygen requirement of newborns in this group. Additionally, the 1-min APGAR scores of the newborns of advanced-age mothers were significantly lower than those of the control newborns, and the pCO2 values measured in the cord or blood gases obtained within the first hour were significantly higher. In healthy pregnancies, no significant differences in APGAR scores or pCO2 values were found between age groups. The cord or blood gas lactate values of newborns who were born from adolescent pregnancies taken within the first hour were significantly higher than those of newborns born in other age groups; considering only healthy adolescent pregnancies, the results did not change. Newborns born from healthy adolescent pregnancies had significantly lower resuscitation needs than those born from other age groups. Conclusions Newborns who are born from adolescent and advanced-age pregnancies are more likely to have risky early post-natal clinical findings than are newborns who were born from mothers 20–34 years of age. The early period clinical approach and follow-up of newborns born from adolescent and advanced-age maternal pregnancies are very important for pediatric management.

Trends and Changes of Maternal Age at Live Birth and Related Statistics in Korea (1981–2019)

Objective: To investigate the changing trends of maternal age at birth in Korea over the past 40 years and related statistics to identify the aging trend. Methods: Population and birth statistics between 1981 and 2019 were obtained from the Statistics Korea. Birth data including total number of births, crude birth rate (CBR), total fertility rate (TFR), and maternal statistics including women''s first marriage age, number of women of childbearing potential, distribution of maternal age at birth, maternal age by birth order, and birth weight by maternal age were reviewed. Results: There was a decrease in the total number of births, CBR and TFR. The average age of women at first marriage increased from 23.2 to 30.6 years and the number of women of childbearing potential decreased from 17.6 million to 15.86 million. The number of advanced maternal age women increased from 3.9% to 33.4% and the number of newborns born to advanced maternal age mothers increased threefold from 33 thousands to 100 thousands. The proportion of low-birth weight infants by maternal age increased among mothers under the age of 20 and mothers of advanced maternal age. Conclusion: We found significant trends in low birth rate, decreased number of women of childbearing potential, later first marriage age and increasing maternal age over 40 years in Korea. In terms of perinatal management, this study intended to provide basic data, aiming at overcoming a rising trend in low birth rate and advanced maternal age.

Advanced maternal age impacts physiologic adaptations to pregnancy in vervet monkeys.

The trend to delay pregnancy in the USA has resulted in the number of advanced maternal age (AMA) pregnancies to also increase. In humans, AMA is associated with a variety of pregnancy-related pathologies such as preeclampsia (PE). While AMA is known to be a factor which contributes to the development of pregnancy-induced diseases, the molecular and cellular mechanisms giving rise to this phenomenon are still very limited. This is due in part to lack of a preclinical model which has physiologic relevance to human pregnancy while also allowing control of environmental and genetic variability inherent in human studies. To determine potential physiologic relevance of the vervet/African green monkey (Chlorocebus aethiops sabaeus) as a preclinical model to study the effects of AMA on adaptations to pregnancy, thirteen age-diverse pregnant vervet monkeys (3-16 years old) were utilized to measure third trimester blood pressure (BP), complete blood count, iron measurements, and hormone levels. Significant associations were observed between third trimester diastolic BP and maternal age. Furthermore, the presence of leukocytosis with enhanced circulating neutrophils was observed in AMA mothers compared to younger mothers. Moreover, we observed a negative relationship between maternal age and estradiol, progesterone, and cortisol levels. Finally, offspring born to AMA mothers displayed a postnatal growth retardation phenotype. These studies demonstrate physiologic impairment in the adaptation to pregnancy in AMA vervet/African green monkeys. Our data indicate that the vervet/African green monkey may serve as a useful preclinical model and tool for deciphering pathological mediators of maternal disease in AMA pregnancy.

Profile of pro-inflammatory cytokines in colostrum of nursing mothers at the extremes of reproductive age.

Gestations at the extremes of reproductive age are characterized as high-risk pregnancies, conditions that might influence colostrum composition. This first milk secretion contains nutrients necessary for the development and immunity of the newborn; therefore, this study aims to compare adolescent and advanced maternal age mothers regarding sociodemographic, gestational, and perinatal characteristics and the colostrum levels of pro-inflammatory cytokines in these groups of study. This cross-sectional study has compared sociodemographic, gestational and perinatal data from adolescent mothers (between 10 and 24 years old) (n = 117), advanced maternal age mothers (over 35 years of age) (n = 39) and mothers considered a control group (25 to 34 years old) (n = 58). Additionally, colostrum samples were obtained from the studied and control group subjects by manual milking, between 48 and 72 hours postpartum, and the samples were analyzed for cytokine concentrations by enzyme-linked immunosorbent assay (ELISA). The majority of the studied mothers reported living a stable union, and 81.2% of the adolescent mothers did not carry out any paid activity. Mothers with advanced maternal age mainly delivered by cesarean section and presented a higher body mass index (BMI). Neonatal weight and Apgar score were not different between the groups. The concentrations of interleukin (IL)-1β and IL-6 were higher in the colostrum of mothers with advanced age compared to adolescent mothers, but did not differ from the control group. The concentrations of IL-8 and tumor necrosis factor alpha did not differ between the three groups. Therefore, our data demonstrated that maternal age influenced the sociodemographic and gestational characteristics as well as the composition of colostrum cytokines.

Antenatal sleep quality associated with perinatal outcomes in women of advanced maternal age

ObjectivesThe increasing prevalence of advanced maternal age (AMA) coupled with poor sleep quality among pregnant women makes it important to study their association with perinatal outcomes. However, little is known about the interaction of AMA and maternal antenatal sleep on perinatal outcomes. Here, we examined whether associations between AMA and perinatal outcomes are modified by antenatal sleep quality. ParticipantsData were collected from 446 women, with a singleton pregnancy and no pregnancy complications, who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study. MeasurementsParticipants completed the Pittsburgh Sleep Quality Index (PSQI) at 26-28 weeks gestation and had perinatal outcome data collected upon delivery. Interactions between AMA and maternal sleep quality on perinatal outcomes were investigated and where significant, analyses were further stratified by maternal age. All analyses were adjusted for maternal BMI at 26-28 weeks gestation, ethnicity, and maternal education. ResultsNeonates of mothers of AMA and poor sleep quality (PSQI score >5) had increased odds of stay in the neonatal intensive care unit (adjusted odds ratio = 3.53, 95% CI: −1.21 to 10.27) and shorter birth length (adjusted mean difference = −1.05 cm, 95% CI: −1.82 to −0.20), as compared with women of AMA and good sleep quality (PSQI score ≤5). In women <35 years, sleep quality did not associate with perinatal outcomes. ConclusionPoor sleep quality in women of AMA was associated with neonatal health outcomes. Improving maternal antenatal sleep may potentially improve perinatal outcomes in offspring of women of AMA.

Impacto da idade materna na acidez do colostro de nutrizes em maternidade do interior do Estado de São Paulo

Objetivo: Analisar as características sociodemográficas e gestacionais e comparar a acidez do colostro de nutrizes adolescentes e idade materna avançada. Método: Estudo prospectivo transversal, que incluiu 98nutrizes adolescentes (até 18 anos) e 33 nutrizes com idade materna avançada (maior que 35) atendidas na Maternidade do Hospital Regional de Presidente Prudente. Amostras de aproximadamente 10 mL de colostro foram obtidas por meio da ordenha manual entre 48 a 72h após o parto, e armazenadas a -20oC até o processamento. A acidez foi verificada por meio da titulação e calculada em graus Dornic. A análise estatística foi realizada utilizando-se o teste de Mann-Whitney ou X2. Resultados: A mediana da idade materna das nutrizes adolescentes foi de 20 (12-24) anos, e das nutrizes com idade materna avançada foi de 37 (35-45) anos. A maioria das nutrizes adolescentes (66,3%) eram primíparas e a via de parto cesárea ocorreu em 66,7% das nutrizes em idade materna avançada. O índice de massa corpórea (IMC) gestacional foi estatisticamente maior em nutrizes com idade materna avançada (31,3±5,6 vs 26,06±3,6, p&lt; 0,0001). A acidez do colostro das nutrizes nos extremos da idade reprodutiva não apresentou diferença significativa entre os grupos de nutrizes. Conclusão: As características sociodemográficas e gestacionais de adolescentes e mães com idade materna avançada evidenciam heterogeneidade dessas populações e consequentemente, atendimento e condutas específicas devem ser aplicados a cada uma. A constituição do colostro em caiseina e proteinas apresentou-se constante, independente da idade materna.

Incidence and risk factors associated with postpartum depression among women of advanced maternal age from Guangzhou, China.

To investigate whether advanced maternal age (AMA) increases the risk of postpartum depression (PPD) at 6 weeks after birth and to explore the risk factors. A cross-sectional study was conducted at 6 weeks postpartum. The Edinburgh Postnatal Depression Scale and a self-designed questionnaire were administered to participants. Multivariate logistic regression was used to determine risk factors. The prevalence of PPD in women of AMA was 18.0%. Poor relationships with mothers-in-law, female fetus, inconsistency between expected sex and actual sex and primiparae were identified as risk factors. Mothers of AMA require specialized care and support to alleviate their concerns.

Trends in Birth Weight and the Incidence of Low Birth Weight and Advanced Maternal Age in Korea between 1993 and 2016.

BackgroundAs the aging society progresses, the average age of mothers is also increasing. Advanced maternal age has been known to be associated with perinatal outcomes, as well as birth weight (BW). In this study, we aimed to investigate the perinatal factors associated with low birth weight infants (LBWIs) using birth statistics of the Korean population.MethodsBirth statistics between 1993 and 2016 from the Korean Statistical Information Service were reviewed. We investigated 12,856,614 data points, which included the number of births, BWs, percentage of preterm births and LBWIs, multiple pregnancies, and maternal age.ResultsThe proportion of LBWIs delivered by mothers of advanced maternal age has gradually increased since 1993. In addition, the proportion of older mothers (≥ 35 years old) giving birth to LBWIs has increased over the years. Average BW has a negative correlation with the ratio of preterm births, LBW, multiple births, and advanced maternal age. The mean BW also has a negative correlation with maternal age.ConclusionThis study shows that the average BW continues to decline, and the incidence of LBWIs is increasing in Korea since 1993. This study also revealed that several perinatal factors, including percentage of preterm births, LBWIs, multiple births, and maternal age influence the mean BW. Although this study did not investigate the effects of decreasing mean BW on perinatal health, future research is worth discussing.

Relationship Between Advanced Maternal Age and Timing of First Developmental Evaluation in Children with Autism.

Mothers of advanced maternal age (AMA) at childbirth (age ≥35 years) may have different perceptions of autism spectrum disorder (ASD) risk, independent of sociodemographic factors, that may affect ASD identification. We aimed to estimate associations between AMA and both age of a child's first evaluation noting developmental concerns and time from first evaluation to first ASD diagnosis. We used data for 8-year-olds identified with ASD in the 2008 to 2012 Autism and Developmental Disabilities Monitoring Network. We estimated differences in age at first evaluation noting developmental concerns and time to first ASD diagnosis by AMA using quantile and Cox regression. Of 10,358 children with ASD, 19.7% had mothers of AMA. AMA was associated with higher educational attainment and previous live births compared with younger mothers. In unadjusted analyses, AMA was associated with earlier first evaluation noting developmental concerns (median 37 vs 40 mo) and patterns in time to first evaluation (hazard ratio: 1.12, 95% confidence interval: 1.06-1.18). Associations between AMA and evaluation timing diminished and were no longer significant after adjustment for socioeconomic and demographic characteristics. Children's intellectual disability did not modify associations between AMA and timing of evaluations. Advanced maternal age is a sociodemographic factor associated with younger age of first evaluation noting developmental concerns in children with ASD, but AMA was not independently associated likely, because it is a consequence or cofactor of maternal education and other sociodemographic characteristics. AMA may be a demographic factor to consider when aiming to screen and evaluate children at risk for ASD.

Sleep quality at 3 months postpartum considering maternal age: A comparative study

BackgroundPoor sleep quality is related to old age among the general population, but few studies have focused on postpartum women of advanced maternal age. The present study aimed to describe and compare sleep quality between women younger or older than 35 years of age at 3 months postpartum, and to examine the related factors. MethodsA cross-sectional survey was conducted with 160 postpartum women who had given birth at a teaching hospital in Taiwan. The participants were assigned to two groups according to age (≥35 years, n=80; and 20–34 years, n=80). Sleep quality was measured using the Pittsburgh Sleep Quality Index with a cut-off score of 5. ResultsThe prevalence of poor sleep quality at 3 months postpartum was higher in older mothers (61.6%) than in younger mothers (38.4%, p<0.01). Multiple logistic regression revealed that poor sleep quality was positively correlated with the severity of postpartum physical symptoms, lack of exercise, and room-sharing with infants. After adjustment for those variables, older mothers were three times more likely to have poor sleep quality than younger mothers (odds ratio=3.08; 95% confidence interval 1.52–6.23). ConclusionHealth care providers should pay attention to sleep problems among postpartum women, especially mothers of advanced maternal age. In particular, health care providers should evaluate sleep quality among postpartum women, instruct them not to share the bed with their infants at night, perform exercise, and manage their postpartum physical symptoms to improve the sleep quality.

Effect of advanced maternal age on birth defects and postnatal complications of neonates

To investigate the effect of advanced maternal age on birth defects and postnatal complications of neonates. Among the 1 109 neonates who were born at The First People's Hospital of Yunnan Province between January 2014 and December 2015, 536 neonates whose mothers were aged ≥35 years were enrolled as advanced age group and 573 neonates whose mothers were aged <35 years were enrolled as appropriate-age group. The incidences of the comorbidities in pregnancy, fetal intrauterine distress, neonatal birth defects, and postnatal complications were compared between the two groups. A univariate logistic regression analysis was performed to analyze the effect of advanced maternal age on neonatal comorbidities during perinatal period. Compared with the appropriate-age group, the advanced age group had significantly higher rate of caesarean section and incidence rates of multiple birth, gestational diabetes, pregnancy-induced hypertension, in vitro fertilization, and fetal intrauterine distress (P<0.01). The neonates in the advanced age group had a significantly higher incidence rate of cleft lip and palate and a significantly lower rate of skeletal dysplasia than in the appropriate-age group (P<0.05). Advanced maternal age was the risk factor for fetal intrauterine distress (OR=2.27, 95%CI: 1.33-3.88, P=0.003), neonatal resuscitation (OR=1.66, 95%CI: 1.19-2.31, P=0.003), and intracranial hemorrhage (OR=2.70, 95%CI: 1.21-6.04, P=0.02). The women of maternal advanced age have higher incidence rates of pregnancy comorbidities than those of appropriate age, and the neonates born to the mothers of advanced maternal age have a higher incidence rate of cleft lip and palate. Advanced maternal age may increase the risks of fetal intrauterine distress, neonatal resuscitation, and intracranial hemorrhage.

Review of the 2015 Guidelines for Maternity Care with relevance to congenital disorders.

The 4th edition of the Guidelines for Maternal Care in South Africa published by the National Department of Health in 2015 was evaluatedwith relevance to the care and prevention of congenital disorders (CDs). Disparate terminology is used for CDs throughout the guidelines,and overall less detail is included on CDs compared with the previous edition. This demonstrates a lack of awareness around the growinghealth need and contribution of CDs to the disease burden in South Africa (SA). Referrals to medical genetic services in the guidelines formothers of advanced maternal age and other high-risk categories do not take into account the insufficient capacity available for screeningand diagnosis of CDs. This highlights the lack of consultation with the medical genetics sector during the development of the guidelines. Torespond to the Sustainable Development Goals by 2030, CDs must be integrated comprehensively at all levels of healthcare in SA.

Effects of advanced maternal age and race/ethnicity on placental weight and placental weight/birthweight ratio in very low birthweight infants.

To study the association of advanced maternal age (AMA) and race/ethnicity on placental pathology in very low birthweight (VLBW) infants. Retrospective analysis of placental pathology of inborn singleton VLBW infants from a regional level 3 NICU between July, 2002 and June, 2009. Subjects were stratified by age and race/ethnicity. Statistical analysis included One-way ANOVA, Chi Square and multivariable analyses. A total of 739 mother/infant dyads were included. AMA was associated with a decrease in placental weight and placental weight/birthweight ratio. Black/Non-Hispanic mothers ≥35 had a lower placental weight (p = 0.01) and lower placental weight/birth weight ratio (z-score, -0.45 ± 0.71 vs -0.04 ± 1.1, p = 0.01) compared to Black/Non-Hispanic mothers <35 years of age. After controlling for gestational age, race/ethnicity, maternal diabetes, maternal smoking, maternal hypertension and clinical chorioamnionitis, AMA, but not race/ethnicity, remained independently associated with placental weight/birthweight ratio z score (full model r(2) = 0.22, p < 0.01). In our study sample of VLBW infants, placental weight and placental weight/birthweight ratio were lower in mothers of advanced maternal age compared to mothers <35 years of age. Our data suggest that maternal age affects placentation in VLBW infants, which could influence maternal and neonatal outcomes.

Perinatal correlates of delayed childbearing in a developing country

To evaluate women with delayed childbearing after 35 years and the perinatal profile of their surviving offspring in a low-income country. A matched case-control study of advanced maternal age (AMA) parturients above 35 years was compared to younger mothers (20-35 years) in an inner-city maternity hospital in southwest Nigeria using conditional logistic regression analysis. A total of 513 were enlisted as cases matched with 1,539 controls. AMA was associated with marital status, occupation, parity, antenatal care and elective cesarean delivery but significantly less likely to be associated with human-immunodeficiency-virus infection and cephalopelvic disproportion. After adjusting for these maternal factors, AMA was not associated with any adverse perinatal outcomes. Delayed childbearing after 35 years was generally not associated with adverse pregnancy outcomes in this setting and may be indicative of an appreciable awareness of the potential pregnancy risks resulting in higher uptake of obstetric services by AMA mothers.

Does very advanced maternal age, with or without egg donation, really increase obstetric risk in a large tertiary center?

to assess complications of very advanced maternal age (VAMA) pregnancies ≥ 45 years with and without egg donation (ED). obstetric and neonatal complications were studied in 20,659 singleton pregnancies according to three maternal age groups: 20-39, 40-44 [advanced maternal age (AMA)] and ≥ 45 years (VAMA). Twenty pregnancies within the AMA/LAMA group that were achieved with ED were compared with age-matched controls. AMA mothers were more likely to have higher rates of preterm deliveries (OR 1.25), cesarean sections (OR 1.84) hypertension (OR 1.71) and diabetes (OR 2.45). Their newborns were more frequently small for gestational age (OR 1.30), and were more likely to have high rates of respiratory distress syndrome (OR 1.66), neonatal intensive care admission (OR 1.40) and perinatal/neonatal mortality (OR 1.83). VAMA pregnancies had >50% cesarean section rate and a high rate of diabetes (OR 2.29), hypertension (OR 1.54) and postpartum hemorrhage (OR 5.38). Congenital anomalies were more common among ED pregnancies. the higher rate of pregnancy complications for women ≥ 40 years is not further increased after 45 years of age.