Effect Of Maternal Age Research Articles

The effect of advanced maternal age on perinatal outcomes in nulliparous pregnancies.

In the current study, we aimed to evaluate the effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancy. The perinatal outcome data of 11,366 patients who gave birth between 2015 and 2020 were evaluated retrospectively. Patients were subgrouped according to their age as control group (C) (20-29years), late advanced maternal age group (30-34years), advanced maternal age group (35-39years), and very advanced maternal age group (≥40years). Multinomial logistic regression analyses were performed to test the possible independent role ofmaternal age as a risk factor for adverse pregnancy outcomes. Statistically significant difference was observed between the control group and the other groups in terms of preterm delivery, preeclampsia, gestational diabetes mellitus (GDM), small gestational age (SGA), large gestational age (LGA), premature rupture of membranes (PROM), high birth weight (HBW), and perinatal mortality rates (p<0.05). An increased risk of the need for neonatal intensive care unit (NICU) and perinatal mortality was observed in groups over 35years old. Age poses a risk in terms of preterm delivery, preeclampsia, LGA, GDM, and HBW in the groups over 30years of maternal age. The rates of PROM, NICU, and perinatal mortality increase in addition to those perinatal results in the groups above 35years of maternal age.

Effects of maternal age on the mode of delivery following induction of labor in nulliparous term pregnancies: A retrospective cohort study.

Increased maternal age at the time of pregnancy and labor is believed to have potential complications. To evaluate the effects of maternal age on the mode of delivery among nulliparous women with term pregnancies who underwent labor induction. In this retrospective cohort study, 313 women with the gestational age of at least ≥37weeks, were enrolled. They were divided based on their maternal ages as: Group A < 35 years old (y/o) and Group B ≥ 35 y/o patients. Demographic features and other variables (i.e., past medical history, social history, indications and methods of labor induction, causes of cesarean delivery) were recorded from patients' files. Final outcomes were categorized as: primary (i.e., rate of cesarean section: C/S) and (b) secondary (i.e., duration of labor, postpartum complications, neonatal variables). All data were analyzed by the SPSS ver.21 software. Median and interquartile ranges of gestational age were not significantly different, comparing the two groups (p = 0.415), although these variables were significantly different regarding maternal height among the two groups (p = 0.007). There was a significant relationship between the methods of labor induction among the two groups (p = 0.005). There was a prominent statistical relationship between (a) C/S deliveries and also (b) indications of C/S among the two groups (p = 0.004 and p = 0.033, respectively). Univariate logistic regression test revealed maternal age groups, neonatal weight, and history of underlying diseases had significant results (p < 0.05). Increased maternal age is associated with higher rates of CS among nulliparous women with term pregnancies who underwent labor induction.

Maternal periconceptional alcohol consumption and gastroschisis in the National Birth Defects Prevention Study, 1997-2011.

Gastroschisis is particularly prevalent among offspring of young women and has increased over recent decades. Although previous studies suggest that maternal alcohol consumption is associated with increased gastroschisis risk, none have explored whether maternal age modifies that association. The objective of the study was to evaluate associations between self-reported maternal periconceptional alcohol consumption (1month prior through the third month after conception) and risk of gastroschisis among offspring, by maternal age. We used data from the National Birth Defects Prevention Study (NBDPS), a multi-site population-based case-control study. The analysis included 1450 gastroschisis cases and 11,829 unaffected liveborn controls delivered during 1997-2011 in ten US states. We estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the individual and joint effects of alcohol consumption and young maternal age at delivery (<25years vs ≥25years) on gastroschisis risk. We estimated the relative excess risk due to interaction (RERI) to quantify additive interaction. Periconceptional alcohol consumption was common regardless of maternal age (women <25years: cases 38.8%, controls 29.3%; women ≥25: cases 43.5%, controls 39.5%). Compared with women ≥25years who did not consume alcohol, we observed increased risk of gastroschisis among women <25years, with higher estimates among those who consumed alcohol (women <25years who did not consume alcohol. aOR 5.90, 95% CI 4.89, 7.11; women <25years who did consume alcohol: aOR 8.21, 95% CI 6.69, 10.07). Alcohol consumption among women ≥25years was not associated with gastroschisis (aOR 1.12, 95% CI 0.88, 1.42). This suggests super-additive interaction between alcohol consumption and maternal age (RERI-2.19, 95% CI 1.02, 3.36). Periconceptional alcohol consumption may disproportionately increase risk of gastroschisis among young mothers. Our findings support public health recommendations to abstain from alcohol consumption during pregnancy.

Chromosomal Microarray Analysis Compared With Noninvasive Prenatal Testing in Pregnancies With Abnormal Maternal Serum Screening

OBJECTIVE: To examine the effect of maternal age on the rate of clinically significant chromosomal microarray analysis results in pregnancies with abnormal maternal serum screening and to establish the residual risk for abnormal microarray findings after omitting noninvasive prenatal testing (NIPT)–detectable aberrations in pregnancies with abnormal maternal serum screening. METHODS: This retrospective study included all chromosomal microarray analysis tests performed in pregnancies with abnormal maternal serum screening and normal ultrasonogram results over the years 2013–2021. The rate of clinically significant (pathogenic and likely pathogenic) chromosomal microarray analysis findings was compared with a local control cohort of 7,235 pregnancies with normal maternal serum screening and ultrasonogram results, stratified by maternal age. Calculation of residual risk for clinically significant chromosomal microarray analysis results after normal NIPT was performed by omission of common NIPT-detectable anomalies. Systematic review for studies examining the yield of chromosomal microarray analysis in pregnancies with abnormal maternal serum screening was performed from inception to October 2021, with no time or language restrictions. RESULTS: Of the 559 amniocenteses performed due to abnormal maternal serum screening, 21 (3.8%; 95% CI 2.4–5.7%) clinically significant chromosomal microarray analysis results were found. The residual risk for chromosomal microarray analysis aberrations after theoretically normal NIPT was estimated to be 2.0% (95% CI 1.1–3.6%) (1/50) and was significantly higher for women younger than age 35 years with abnormal maternal serum screening, compared with women with low-risk pregnancies. Systematic review yielded six articles encompassing 4,890 chromosomal microarray analysis results in pregnancies with abnormal maternal serum screening, demonstrating 2.3% residual risk for chromosomal microarray analysis anomalies after theoretically normal NIPT. DISCUSSION: Clinically significant chromosomal microarray analysis findings can be found in 1 of every 50 pregnancies with high-risk maternal serum screening after theoretically normal NIPT, implying that invasive testing and not NIPT should be recommended in such pregnancies. In addition, NIPT use as a first-tier screening modality instead of maternal serum screening would miss pregnancies at increased risk not only for common autosomal trisomies but for additional chromosomal microarray analysis–detectable disorders.

Frequency of Grades of Meconium-Stained Liquor and Compare the Frequency of Fetal Outcome according to Grades of Meconium-Stained Liquor

Objective: To determine the different grades of meconium-stained liquor and association of fetal outcome (still birth, poor Apgar score, NICU admissions) among meconium-stained liquor patients according to their grades. Subject and Methods: This prospective case series study was conducted at the department of obstetrics and Gynaecology, civil Hospital Karachi, for 6 months from April 2019 to September 2019. After per vaginal examination meconium-stained amniotic liquor and grades of meconium-stained liquor were confirmed and these patients were monitored by auscultation of fetal heart sounds by pinard stethoscope and cardiotocography performed and when patients delivered, the frequency of fetal outcome according to grades noted and was documented on pre-designed proforma. Results: A total of 150 patient women were studied, their average age was 28.62±4.19 years and mean gestational age was 38.38+1.00 weeks. There 56% multiparous women. Of all meconium-stained liquor, grade II was commonest 40%, grade I 30% and grade III 30%. Still birth was 2.0%, poor Apgar score was 24.7% and rate of NICU admission was 28.0%. Maternal age, parity and gestational age effects were statistically significant on grade of liquor (p-&lt;0.05). Conclusion: Meconium-stained liquor grade II was observed to be high. The adverse fetal outcomes in terms of still birth, low Apgar score and neonatal intensive care unit admission were observed to the significancy associated with meconium-stained liquor grades II and III. Meconium-stained amniotic fluid as a serious problem so early decision should be taken to improve the fetal outcome. Keywords: Meconium-stained amniotic fluid, still birth, poor Apgar score

Impact of Maternal Age on Singleton Birthweight in Frozen Embryo Transfer Cycles.

BackgroundPrevious studies have investigated the effect of maternal age on assisted reproductive technology success rates. However, little is known about the relationship between maternal age and neonatal birthweight in frozen embryo transfer (FET) cycles. Whether maternal age influences singleton birthweight in FET cycles remains to be elucidated.MethodsThis study was conducted at a tertiary care center, involving singleton live births born to women undergoing frozen–thawed embryo transfer during the period from January 2010 to December 2017. A total of 12,565 women who fulfilled the inclusion criteria were enrolled and grouped into four groups according to the maternal age: <30, 30–34, 35–39, and ≥40 years old. A multivariable linear regression analysis was conducted to reveal the relationship between maternal age and neonatal birthweight with controlling for a number of potential confounders.ResultsThe highest proportions of low birthweight (LBW, 4.1%), high birthweight (1.2%), preterm birth (PTB, 5.9%), and very PTB (0.9%) were found in the group over 40 years old, but no significant difference was observed among the four groups. Additionally, the 35–39-year-old group had the highest rate of very LBW (0.6%), whereas the 30–34-year-old group had the lowest rate of small for gestational age (SGA, 2.7%). However, multivariate analyses revealed that neonatal outcomes including PTB, LBW, and SGA were similar between the different maternal age groups.ConclusionGrouping with different maternal age was not associated with mean birthweight and Z-scores of singletons resulting from FET.

Advanced Maternal Age Impairs Myelination in Offspring Rats.

The effects of advanced maternal age (AMA) on the neurodevelopment of offspring are becoming increasingly important. Myelination is an important aspect of brain development; however, a limited number of studies have focused on the effects of AMA on myelination in offspring. The current study aims to evaluate the association between AMA and myelin sheath development in offspring. We studied the learning and memory function of immature offspring using the novel object recognition test. Then, we investigated the expression of myelin basic protein (MBP) in the immature offspring of young (3-month-old) and old (12-month-old) female rats at different time points (14, 28, and 60 days) after birth with immunofluorescence and western blotting. The myelin sheath ultrastructure was observed with transmission electron microscopy in immature and mature offspring. Extracellular signal-regulated kinase 1 and 2 (ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2) were investigated by western blot in immature offspring at the above time points. AMA impaired the memory function of offspring during early postnatal days. The MBP expression level gradually increased with postnatal development in the offspring of both the AMA and Control (Ctl) groups, but the MBP level in the offspring of the AMA group was lower than that of the Ctl group at 14 days after birth. In addition, the ultrastructure of the myelin sheath was defective in AMA offspring during the early postnatal period; however, the myelin sheath was not significantly affected in offspring during adulthood. Interestingly, ERK phosphorylation at 14 days after birth was lower in AMA offspring than in Ctl offspring. However, ERK phosphorylation at 28 days after birth was higher in AMA offspring than in Ctl offspring. The peak of ERK phosphorylation in the AMA group was abnormal and delayed. Our results indicated that AMA is associated with poor developmental myelin formation in offspring. The ERK signaling pathway may play an essential role in the adverse effects of AMA on the offspring myelin sheath development.

Maternal age and maternal environment affect egg composition, yolk testosterone, offspring growth and behaviour in laying hens

Maternal effects have been reported to alter offspring phenotype in laying hens. In this study, we investigated the effects of maternal environment and maternal age on egg traits and offspring development and behaviour. For this, we ran two experiments. First (E1), commercial hybrid hens were reared either in aviary or barren brooding cages, then housed in aviary, conventional cages or furnished (enriched) cages, thus forming different maternal housing treatments. Hens from each treatment were inseminated at three ages, and measures of egg composition, yolk testosterone concentration and offspring’s development, anxiety and fearfulness were assessed. In experiment 2 (E2), maternal age effects on offspring's growth and behaviour were further investigated using fertile eggs from commercial breeder flocks at three different ages. Results from E1 showed that Old hens laid heavier eggs with less yolk testosterone and produced offspring with fewer indicators of anxiety and fearfulness. Maternal rearing and housing affected egg traits, offspring weight and behaviour, but not in a consistent way. Effects of maternal age were not replicated in E2, possibly due to differences in management or higher tolerance to maternal effects in commercial breeders. Overall, our research confirms that maternal age and maternal environment affects egg composition, with maternal age specifically affecting yolk testosterone concentration, which may mediate physical and behavioural effects in offspring.

Association between cesarean section rate and maternal age in twin pregnancies

To evaluate the effect of maternal age to the cesarean section rate of twin pregnancies in late preterm and term gestation. A retrospective study was performed on twin pregnancies delivered at Seoul National University Bundang Hospital from June 2003 to December 2020. Preterm births before 34weeks of gestation were excluded, and only live births were analyzed. The patients were classified into four groups according to maternal age (<30, 30-34, 35-39, and≥40 years). The primary outcome was the rate of cesarean section. The median value of maternal body mass index, the rate of assisted reproductive technology, dichorionic twin pregnancy, preeclampsia, and gestational diabetes increased significantly according to the maternal age group (all p<0.05). Among a total of 2,075 twin pregnancies, the rates of cesarean section were 65, 74, 80, and 95% for groups with maternal age under 30, 30-34, 35-39, and≥40 years, respectively (p<0.001). The cesarean section rates after a trial of labor were 22, 22, 28, and 63%, respectively (p=0.032). Maternal old age was an independent risk factor for cesarean section after a trial of labor in both nulliparous and multiparous women after adjusting for confounding factors. The rate of cesarean section in twin pregnancies significantly increased as maternal age increased, even in multiparous women.

Inequalities in Birth Weight in Relation to Maternal Factors: A Population-Based Study of 3,813,757 Live Births.

Background: Despite numerous studies of women having children later in life, evidence of the relationship between maternal factors and newborn outcomes in Central and Eastern European countries is limited. This study aimed to examine the association between maternal age, biological determinants, including parity and sex of the newborn, demographic and social background, and birth weight in 3.8 million singleton live births in Poland. Methods: The effect of maternal age on birth weight (in grams and Z-scores) adjusted for confounders was assessed using Generalized Linear Models. Results: The mean (±SD) birth weights of neonates born to primiparous women and multiparous women were 3356.3 ± 524.9 g and 3422.7 ± 538.6 g, respectively, which corresponded to a Z-score of −0.07 ± 0.96 and 0.14 ± 1.00, respectively (p ≤ 0.001). After controlling for biological, demographic, and social factors, a significant decrease in birth weight was found for primiparous women of the age group ≥30 years and multiparous women aged ≥35 years compared to the age group of 25–29 years. The lowest neonatal birth weight was observed in the case of women aged ≥45 years. Confounders did not affect birth weight Z-scores among primiparous women, whereas among multiparous women, together with educational factors, they reversed Z-scores from positive to negative values. The lower birth weight of neonates was overall associated with lower maternal education. Conclusions: Regardless of parity, advanced maternal age is strongly associated with a decreased neonatal birth weight, implying complications in early pregnancy and the antenatal period as well as obstetric complications. Counseling to support women’s family planning decisions and improving women’s education during their reproductive age may help to alleviate unfavorable newborn outcomes.

Factors Affecting Sectio Caesarea Delivery at the Padangsidimpuan City Regional General Hospital

Indonesia is one of the countries with the highest maternal mortality rate (MMR) in Asia compared to other ASEAN countries, reaching 359 maternal deaths per 100,000 births. This study aims to determine the Factors Affecting Sectio Caesarea Delivery in Regional General Hospitals Padangsidimpuan City 2018. The research design is an observational analytic study with a case control design and takes 100 respondents, consisting of 50 cases and 50 controls. Data collection was carried out using a check list sheet which was carried out in July 2018. The results of the hypothesis test showed that there was an effect of maternal age (p=0.001; OR 10.5), fetal position abnormalities (p=0.004; OR 9.2), prolonged labor (p=0.005; OR 8.5), premature rupture of membranes ( p=&lt;0.000 OR 23.1), and placenta previa (p=0.001; OR 60.3) with cesarean section delivery and there was no effect of macrosomia (large baby) with cesarean section delivery (p=0.092) in Padangsidimpuan City Hospital. The dominant variable was placenta previa (p=0.001; OR 60.3; 95% CI 5,437-668,215). It is recommended to pregnant women to provide information about sectio caesarea and provide counseling to mothers who check their pregnancy so that mothers better understand risky conditions and can prepare themselves to avoid them.

Maternal and Paternal Age Effects on Male Antler Flies: A Field Experiment.

AbstractIn many species, parental age at reproduction can influence offspring performance and life span, but the direction of these effects and the traits affected vary among studies. Data on parental age effects are still scarce in noncaptive populations, especially insects, despite species such as fruit flies being models in laboratory-based aging research. We performed a biologically relevant experimental manipulation of maternal and paternal age at reproduction of antler flies (Protopiophila litigata) in the laboratory and tracked the adult life span and reproductive success of their male offspring released in the wild. Increased paternal, but not maternal, age somewhat increased sons' adult life span, while parental ages did not influence sons' mating rate or reproductive senescence. Our results indicate that while parental age effects do exist in an insect in the field, they may be beneficial in such a short-lived animal, in contrast to results from most wild vertebrates and laboratory invertebrates.

Effect of Maternal Age and Anaemia on Auditory Brainstem Response of Preterm Infants in a Tertiary Care Hospital of Kolkata, West Bengal: A Cross-sectional Study

Introduction: Adolescent pregnancy and maternal anaemia have a detrimental effect on infant growth and development. They are associated with greater risk of premature births and Low Birth Weight (LBW). Wave Interpeak Latencies (IPLs) of infant Auditory Brainstem Response (ABR) indicate the degree of maturation of brainstem auditory pathways among preterm infants. Previous studies indicated that preterm infants show prolonged wave Interpeak Latencies (IPLs). Whether maternal parameters like age and haemoglobin level contributes to the changes in infant ABR is debated. Aim: To study the effect of maternal age and anaemic status on Brainstem Evoked Response Audiometry (BERA) changes among preterm infants. Materials and Methods: An observational, descriptive study of cross-sectional design was undertaken in the Neurophysiology laboratory of Department of Physiology, RG Kar Medical College and Hospital, Kolkata from December 2019 to December 2022. Total of 119 mother-preterm infant dyads were included. Click BERA was performed on the babies aged between 3 months to 1 year. Absolute and IPLs of wave I,III and V were obtained. Mothers were assigned anaemic status {Haempglobin (Hb) level&lt;9gm/dL} based on the information in their antenatal card. Student’s t test, Fisher’s exact test, one way ANOVA test were used for data analysis. A p-value less than 0.05 was considered significant. Results: Out of 76 adolescent mothers (age between 10 to &lt;18 years), 43 (56.6%) were anaemic. Out of 43 adult mothers (with age ≥18 years), 33 (76.7%) were anaemic. Mothers were divided into four groups, namely adolescent anaemic (n=43) and adolescent non anaemic (n=33), adult anaemic (n=33) and adult non anaemic (n=10). Distribution of data with respect to education years, social class and occupation among four mothers’ group was comparable [p-value&gt;0.05]. Preterm infants born to both anaemic adult [Hedges g=2.51] and anaemic adolescent mothers [Hedges g=1.06] showed dyssynchronous shortening of wave latencies compared to non anaemic counterparts (p-value&lt;0.05). Magnitude of difference with respect to infant ABR for non anaemic adolescent mothers vs non anaemic adult counterparts was large [Hedge s g=1.05] with p-value&lt;0.05. While maternal anaemia showed either shortening or prolongation of IPLs, adolescent maternal age was related with prolongation of the wave I-V. Effect size of maternal anaemia on infant ABR was more than for adolescent maternal age. Conclusion: Maternal anaemia may exaggerate abnormal maturation of the brain stem pathways in preterm infants irrespective of maternal age.

Impact of maternal age on perinatal outcomes in twin pregnancies: a systematic review and meta-analysis.

Current evidence of the maternal, perinatal and neonatal outcomes in twin pregnancies among mothers with advanced age is unclear, especially for mothers with age above 40 years. A systematic search was conducted using the PubMed, Scopus, and Google Scholar databases. Studies that were observational in design or analysed retrospective data were considered for inclusion. The included studies had to be conducted in twin pregnancies and should have documented the effect of maternal age on obstetric and/or neonatal outcomes. Statistical analysis was performed using STATA software. A total of 20 studies were considered for inclusion. All the studies were based on retrospective data. Compared to mothers aged under 40 years, those with advanced age (≥40 years) had increased risk of caesarean delivery [RR 1.20, 95% CI: 1.05, 1.37], gestational hypertension [RR 2.71, 95% CI: 1.72, 4.27], gestational diabetes mellitus [RR 2.03, 95% CI: 1.28, 3.21], preterm birth [RR 2.47, 95% CI: 1.09, 5.80], neonatal admission to intensive care unit [RR 1.78, 95% CI: 1.21, 2.64] and perinatal and/or neonatal mortality [RR 5.76, 95% CI: 1.11, 29.7]. The risk of gestational diabetes mellitus [RR 1.52, 95% CI: 1.21, 1.90] and having caesarean delivery [RR 1.19, 95% CI: 1.10, 1.28] was higher in mothers with ≥35 years of age, compared to those <35 years. There were no significant differences in the risk of adverse neonatal outcomes among the mothers with age ≥35 years. However, in these mothers, the risk of perinatal/neonatal mortality [RR 0.82, 95% CI: 0.76, 0.88] was comparatively lower than in mothers under 35 years of age. There appeared no significant risk of advanced maternal age for postpartum haemorrhage, hospitalization during pregnancy and premature rupture of membranes. The increased risk of maternal, neonatal and perinatal outcomes in mothers with advanced age highlights the need for close follow-up, early detection and management of medical complications in twin pregnancies.

Breast-feeding rate comparison by parity and delivery age in Japan.

To examine the effects of maternal age on breast-feeding, we classified mothers who delivered vaginally aged 20-42 into 1-year age groups and investigated breast-feeding states. We also studied differences between primiparas and multiparas in breast-feeding. The subjects were 2,605 primipara mothers (age at delivery ranged from 16to 45 years; the gestational age of their infants ranged from 37 to 42 weeks, birthweight ranged from 2,501 to 4,300 g) and 3,261 multipara mothers (age 18-45 years; the gestational age of their infants ranged from 37-42 weeks, and their birthweight ranged from 2,502-4,726 g) at 12 baby-friendly hospitals in Japan. The percentage of infants exclusively breast-fed at 1 week and 1 month after birth in the primipara mothers was 80% among mothers in their 20s but lower than 60% among mothers aged above 35. On the other hand, the percentage of infants exclusively breast-fed in the multipara mothers was almost 90% among mothers in their 20s and remained at 70% or over among mothers in their 40s. The percentage of infants exclusively breast-fed was significantly higher in the multipara mothers than in the primipara mothers in many age groups at both 1 week and 1 month of age. The percentage of infants exclusively breast-fed rate decreased as the maternal age increased. We found that multipara mothers can breast-feed even in their 40s, but primipara mothers may encounter difficulty breast-feeding at ages above 35. Our results suggest a need to consider not only their age but number of children, i.e., breast-feeding experience, to provide effective support to breast-feeding mothers.

The implications for advanced maternal age on pregnancy complications and adverse neonatal outcomes

Objective This study aimed to determine the effect of advanced maternal age (AMA) on maternal and neonatal outcomes in pregnant women aged ≥35 years compared with patients aged 30–34 years. Also, we aimed to analyze the risk estimates of potential confounders to identify whether these variables contributed to the development of adverse pregnancy outcomes or not. Methods This retrospective cohort study included 2284 pregnant women aged ≥35 years at the time of delivery who was delivered in a tertiary referral hospital from January 1, 2016, to December 31, 2020. We further classified these women into two subgroups: 35–39 years as early AMA (EAMA), and ≥40 years as very AMA (VAMA). Pregnancy complications and adverse neonatal outcomes were recorded. Results Compared to younger women, pregnant AMA women had significantly higher risks of complicated pregnancies, including a higher risk of gestational diabetes mellitus (GDM, p&lt;0.001), polyhydramnios (p&lt;0.001), cesarean section (p&lt;0.001), stillbirths (p&lt;0.001), major fetal abnormality (p&lt;0.001), preterm delivery (p&lt;0.001), lower birth weight (p&lt;0.001), lower 5-minute Apgar scores (p&lt;0.001), lower umbilical artery blood pH values (p&lt;0.001), neonatal intensive care unit (NICU) admission (p&lt;0.001), and length of NICU stay (p&lt;0.001). Conclusion We found a strong and significant association between VAMA and adverse pregnancy outcomes, including an increased risk of GDM, polyhydramnios, cesarean section, and adverse neonatal outcomes, including a higher risk of stillbirths, preterm delivery, lower birth weight, lower 5-minute Apgar scores, and NICU admission.

Increased proliferation and differentiation capacity of placenta-derived mesenchymal stem cells from women of median maternal age correlates with telomere shortening.

Mesenchymal stem cells (MSCs) experience functional decline with systemic aging, resulting in reduced proliferation, increased senescence, and lower differentiation potential. The placenta represents a valuable source of MSCs, but the possible effect of donor age on the properties of placenta-derived mesenchymal stem cells (PDMSCs) has not been thoroughly studied. Thus, the aim of this study was to underscore the effect of maternal age on the biological characteristics and stemness properties of PDMSCs. PDMSCs were isolated from 5 donor age groups (A: 18-21, B: 22-25, C: 26-30, D:31-35 and E: ≥36 years) for comparison of morphological, proliferative and differentiation properties. The pluripotency markers NANOG, OCT4, and SSEA4, as well as multipotency and differentiation markers, showed higher expression in PDMSCs from mothers aged 22-35 years, with up to a 7-fold increase in adipogenesis. Cumulative population doubling, cell growth curves, and colony-forming unit-fibroblast assays revealed higher self-renewal ability in donors 26-30 years old. An increase in the proliferative characteristics of PDMSCs correlated with increased telomere shortening, suggesting that shorter telomere lengths could be related to cellular division rather than aging. A clear understanding of the effect of maternal age on MSC regenerative potential will assist in increasing the effectiveness of future cell therapies.

First-Trimester Reference Intervals for Thyroid Function Testing among Women Screened at a Tertiary Care Hospital in India.

Objectives Due to differences in the method of assay and population-specific factors, each laboratory needs to establish its own gestation-specific reference intervals (GRIs) for thyroid hormones. Materials and Methods Three-hundred forty-one women with less than 14 weeks gestation were screened at a tertiary care hospital in Chhattisgarh, India. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), and thyroid peroxidase antibody (anti-TPO) were measured using an ADVIA Centaur XP immunoassay. GRIs (2.5th and 97.5th percentiles) were determined for TSH and fT4. TSH and fT4 concentrations were converted to multiples of the median (MoM) values. Effect of maternal age, gestational age, and maternal weight was analyzed.Statistical Analysis Quantitative variables were expressed as means and standard deviations (SD), and qualitative variables were expressed as frequencies and percentages. Normality of the data was checked using the Kolmogorov–Smirnov test. Values that were normally distributed were expressed only as means and SD. Those that were not normally distributed were expressed as medians and interquartile range. For all statistical analysis, p < 0.05 was considered as statistically significant. Results First-trimester GRI was 0.245 to 4.971 mIU/L for TSH, 10.2 to 18.9 pmol/L for fT4, and 27.0 to 56.89 kIU/L for anti-TPO. There was no significant difference in the mean serum TSH ( p = 0.920), fT4 ( p = 0.714), or anti-TPO ( p = 0.754) values among women in 4 to 7th week and 7 to 14th week of gestation. The 1st and 99th centile MoMs were 0.03 and 4.09 for TSH and 0.66 and 1.39 for fT4. There was a significant positive correlation between the maternal weight and TSH MoM values ( p = 0.027, r = 0.120). Conclusion These laboratory- and first-trimester-specific GRI for TSH and fT4 shall help in proper diagnosis and treatment of subclinical thyroid dysfunctions. TSH and fT4 MoM values can be used to indicate high or low values in a quantitative manner independent of the reference ranges and may be used by other laboratories.

Iatrogenic factors contributed to the high rate of preterm birth in a community hospital.

BackgroundPreterm birth (PTB) rates have been increased significantly in recent years, mostly due to obstetric intervention. This study presents the incidence of PTB in community hospitals by assessing the association between pregnancy complications and iatrogenic PTB.MethodsA total of 6,693 pregnancies were enrolled in the Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University. They were divided into two groups (<35 and ≥35 years of age) to examine the effect of maternal age on PTB. Binary logistic and multiple linear regression analyses were used to assess the relationship between PTB and pregnancy complications.ResultsThis study provided the incidence of PTB and found that PP, PROM, and ICP increased the risk of PTB, indicating that pregnancy complications have led to the iatrogenic PTB and contributed to the high rate of PTB, especially in the group of advanced-age pregnant women. The prevalence of PTB was 9.53%. Placenta previa (PP), premature rupture of membranes (PROM), and intrahepatic cholestasis of pregnancy (ICP) were significantly associated with PTB. Among all the risk factors, hypertension, disease in pregnancy, premature PROM, and PP were observed as independent key factors for iatrogenic PTBs. In the advanced-age group, PP and pPROM increased the risk of PTB.ConclusionsIt is often necessary to terminate a pregnancy in community hospitals to balance the safety of the fetus and the maternal comorbid symptoms, which has led to nosocomial premature delivery. Therefore, high-risk pregnancies should be carefully evaluated and comprehensively treated with caution to balance the preterm rate and the safety of the pregnant woman and fetus, and the pros and cons of the outcomes, which has brought a challenge to an obstetrician to reduce the proportion of iatrogenic PTB.

Awareness of paternal age effect disorders among Japanese pregnant women: implications for prenatal genetic counseling for advanced paternal age.

The increasing prevalence of advanced paternal age (APA) has mirrored the rise in maternal age. APA is associated with an increased risk of de novo pathogenic single-nucleotide variants, but this topic has been much less frequently discussed than advanced maternal age (AMA). To explore the awareness of pregnant women regarding paternal age effect (PAE) disorders, a self-administered questionnaire survey was conducted for pregnant women at their first prenatal visit before 17weeks of gestation. A total of 120 valid respondents (95.2%) were included in the analyses. Of these, 63.3% of pregnant women were aware of PAE disorders. This was markedly lower than the 90.8% recognition of maternal age effect (MAE) disorders. One-third of women with awareness of MAE disorders were not aware of PAE disorders. Pregnant women who were parous, older than their male partners, with knowledge of prenatal testing prior to this pregnancy, and with experience of prenatal testing in a prior pregnancy were significantly more aware of PAE disorders than others. Awareness of PAE disorders was not associated with undergoing prenatal testing during the present pregnancy. Our results show that the prevalence of pregnant women's awareness of PAE disorders was lower than that of MAE disorders. The current study served as a preliminary baseline of information about pregnant women's awareness of PAE disorders. With the introduction of non-invasive prenatal testing, which has the potential to identify PAE disorders, these findings will help the development of a framework for comprehensive prenatal genetic counseling for APA pregnancies.