Effect Of Advanced Maternal Age Research Articles

The effect of advanced maternal age on pregnancy outcomes: A prospective study

The effect of advanced maternal age on pregnancy outcomes: A prospective study

The effect of maternal age on still birth in Africa: A systematic review and meta-analysis.

Stillbirth is a public health as well as a development problem in low and middle-income countries. The studies that found out maternal age as a factor for the risk of stillbirth reported different findings. This systematic review and meta-analysis is believed to fill the inconclusiveness of these findings. Hence, the aim of this systematic review and meta-analysis is to estimate the pooled effect of advanced maternal age on stillbirth in Africa. PubMed & HINARY databases and Google Scholar search engine were searched to access the primary studies. The extracted data using Microsoft excel was exported to Stata 15 software for analysis. The presence of heterogeneity was checked using Cochran's Q statistic and the I 2 test. Publication bias was examined by using funnel plot and Egger's test. The pooled effect measure with DerSimonian and Laird method of random-effect model was reported using odds ratio (OR) with respective 95% confidence interval. Totally, 14 articles are included for the systematic review and meta-analysis. The stillbirth reported by the studies ranges from 15 to 146.7 per 1000 births. The overall OR of advanced maternal age (≥35 years) on stillbirth is 1.42 (1.18, 1.71) when compared with the age group of 20-35 years. The cumulative effect of getting pregnant at advanced age on stillbirth was slightly increasing from year to year. Advanced maternal age is a risk factor for stillbirth. Health Information Communication on the risk of getting pregnant at the advanced ages on stillbirth should be well addressed to all women of reproductive age group.

The interrelation between the high expression level of MIR34a and the trisomic abortion materials.

The underlying mechanism and constitution of spontaneous abortions are complicated and heterogeneous. Many factors, including epigenetic scenarios like micro-ribonucleic acids (miRNAs, MIRs), can additively affect the progression of pregnancy losses. This study aimed to evaluate whether the expression levels of placental inhibitor and/or activator miRNAs had a difference between the numerically abnormal and normal karyotyped spontaneous abortions. The case-control study included 100 spontaneous abortion materials consisting of trophoblastic tissues with 42 disomies (controls), 43 aneuploidies (including trisomy 16, 21, 22, and monosomy X), and 15 triploidies. Disomic abortion materials with XX normal karyotypes were omitted from the study to exclude possible maternal decidual cell contamination. Total RNA isolation was performed with TRIzol™ reagent directly from frozen trophoblastic tissues, and the mature miRNAs were obtained by reverse transcription via quantitative real-time polymerase chain reaction (qRT-PCR). Then, the expression levels of placental activators MIR378a-5p, MIR376c, MIR195, and inhibitors MIR34a and MIR210 were relatively evaluated using MIR130 as a reference. The expression level of placental inhibitor MIR34a was detected to be high in trisomic abortion materials (trisomy 16 and 21) when compared to the disomic ones (p = 0.0324). MIR195 (p = 0.0484) and MIR34a (p = 0.0346) expression levels were increased in numerically abnormal cases with advanced maternal age compared to the disomic ones within all maternal ages. It seems likely that the high expression level of MIR34a and the coexistence of trisomic abortion materials are quite interrelated with the additive effect of advanced maternal age.

Effect of advanced maternal age on ischemic stroke vulnerability in aged rats: Investigating on blood-brain barrier permeability and gene expression

BackgroundAdvanced maternal age (AMA), commonly defined as pregnancy at or above 35 years old. Based on the evidence, this trend has raised concerns about potential health consequences for mothers, particularly in relation to ischemic stroke. Studies suggest that AMA may be associated with a higher risk of ischemic stroke in women due to physiological changes that impact vascular health and increase cardiovascular risk factors. The aim of this study was to investigate the effect of AMA on the extent of damage after ischemic stroke in aged rats. MethodsFemale rats that gave birth at an old age (10 months) and at a young age (4 months) were subjected to ischemic stroke in old age (20 months) and subsequently compared.We assessed neurological deficits, infarct volume, blood–brain barrier (BBB) permeability, TNF-alpha levels, total oxidant capacity, and gene expressions that play a role in BBB integrity (VEGF, Occludin, and MMP-9) following ischemic stroke. ResultsThere were significantly elevated levels of MMP-9 expression and reduced levels of occludin in AMA rats. Additionally, AMA rats had significantly higher levels of TNF-alpha and total oxidant capacity after experiencing an ischemic stroke. AMA rats showed significantly higher brain water content (BBB permeability), infarct volume, and neurological deficits compared to young-aged pregnancies. DiscussionComplex relationship between pregnancy-related physiological changes, aging, vascular gene expression, and inflammatory factors may play a role in the increased vulnerability observed in older pregnant rats. The similarities between pregnancy-related alterations and aging highlight the influence of advanced maternal age on susceptibility to ischemic stroke.

#38 : Maternal Age Affects Morula Compaction and Cell Polarity of Human Embryos

Background and Aims: With the exception of chromosome segregation errors, the molecular and biochemical mechanisms responsible for advanced maternal age (AMA)-related reduced embryo developmental competence remain unclear. In women of AMA, the blastocyst formation rate has been reported to decline due to an increase in embryo arrest at the morula stage. Therefore, we aimed to reveal the impact of AMA on cellular events during compaction, as assessed using morphokinetic analysis. We also assessed the possible influence of AMA on the expression of cell polarity markers, yes-associated protein (YAP) and protein kinase C-[Formula: see text] (PKC[Formula: see text]), during blastomere compaction. Method: We retrospectively analysed 2,058 fertilized oocytes, which were stratified by maternal age according to the Society for Assisted Reproductive Technology classification (< 35, 35-37, 38–40, 41–42, and > 42 years). The effects of AMA were assessed in relation to embryo morphokinetics and morphological alterations. Furthermore, 20 voluntarily donated human embryos were used for immunofluorescence staining of YAP and PKC-[Formula: see text]. Results: Delayed embryonic compaction and an increased number of extruded blastomeres post compaction were observed in the > 42-year group. The time interval from the eight-cell stage to compaction initiation was prolonged with increasing age. The number of YAP-positive cells in the outer cells of the morulae was significantly higher in the young age group than in the AMA groups. The PKC[Formula: see text] fluorescence intensity in the cortical region of the morulae was significantly lower in the AMA groups than in the young age groups. Conclusion: Delayed compaction and blastomere extrusion occur more frequently in embryos from women of AMA due to insufficient regulation of cell polarity, which may lead to morula arrest. Further research is required to reveal the impacts of AMA on the mechanism underlying the expression of cell polarity factors and develop methods to avoid AMA-associated morula arrest.

Paternal age does not jeopardize the live birth rate and perinatal outcomes after in vitro fertilization: an analysis based on 56,113 frozen embryo transfer cycles

BackgroundThe global trend of delaying childbearing has led to an increasing number of couples seeking in vitro fertilization. The adverse effects of advanced maternal age on pregnancy and perinatal outcomes are well-documented, regardless of the conception method. Advanced paternal age may also contribute to poor reproductive potential due to high levels of sperm DNA fragmentation. However, it remains challenging to provide guidance to older men regarding the impact of paternal age on pregnancy and birth outcomes in the field of assisted reproduction. ObjectiveTo investigate the association of paternal age with live birth and perinatal outcomes following in vitro fertilization-frozen embryo transfer. Study DesignA retrospective study was performed at a university-affiliated fertility center, involving women who were younger than 36 years and had undergone frozen embryo transfer from January 2011 to June 2021. Subjects were categorized into 6 groups based on paternal age: <25, 25-29, 30-34, 35-39, 40-44, and ≥45 years of age. A generalized estimating equation logistic regression model was used to account for the clustered nature of data and to adjust for confounders. Paternal age between 25-29 years served as the reference group in the logistic regression models. ResultsA total of 56,113 women who met the inclusion criteria were included for final analysis. On unadjusted analyses, the reproductive outcome parameters showed a significant decline with increasing male age. The live birth rate decreased from 47.9% for men aged 25-29 years to 40.3% for those aged ≥40 years. Similarly, the clinical pregnancy rate decreased from 54.4% in the reference group to 47.8% in the ≥40 years age group. Conversely, the miscarriage rate increased as male age increased, from 10.2% among men aged 25-29 years to 13.5% for those aged ≥45 years. However, the differences in the reproductive outcomes mentioned above were no longer significant in the multivariable models. Compared to the younger controls, advanced paternal age was not associated with a lower chance of live birth (adjusted odds ratio [OR], 0.94; 95% confidence interval [CI], 0.85-1.04, and adjusted OR, 0.93; 95% CI, 0.79-1.10, for males aged 40-44 years and ≥45 years, respectively). Additionally, the rates of clinical pregnancy (adjusted OR, 0.95; 95% CI, 0.85-1.05, and adjusted OR, 0.94; 95% CI, 0.79-1.12, for males aged 40-44 years and ≥45 years, respectively) and miscarriage (adjusted OR, 1.05; 95% CI, 0.85-1.31, and adjusted OR, 1.07; 95% CI, 0.77-1.50, for males aged 40-44 years and ≥45 years, respectively) were comparable between the reference and advanced paternal age groups. Furthermore, men in the youngest age group (<25 years) did not have worse pregnancy outcomes compared to those in the reference group. Regarding perinatal outcomes, there were no differences between the study cohorts in terms of preterm birth, low birthweight, macrosomia, small-for-gestational-age, and large-for-gestational-age, both in the unadjusted and confounder-adjusted models. ConclusionThis study did not demonstrate a significant association between paternal age and live birth and perinatal outcomes following in vitro fertilization-frozen embryo transfer when the female partners were younger than 36 years. With the global trend towards delaying childbirth, our findings provide useful information for counseling patients that increasing paternal age may not adversely affect pregnancy and perinatal outcomes in assisted reproduction.

Increased stiffness of omental arteries from late pregnant women at advanced maternal age.

Advanced maternal age (≥35 years) is a risk factor for poor pregnancy outcomes. Pregnancy requires extensive maternal vascular adaptations, and with age, our blood vessels become stiffer and change in structure (collagen and elastin). However, the effect of advanced maternal age on the structure of human resistance arteries during pregnancy is unknown. As omental resistance arteries contribute to blood pressure regulation, assessing their structure in pregnancy may inform on the causal mechanisms underlying pregnancy complications in women of advanced maternal age. Omental fat biopsies were obtained from younger (<35 years) or advanced maternal age (≥35 years) women during caesarean delivery (n = 7-9/group). Arteries (200-300 µm) were isolated and passive mechanical properties (circumferential stress and strain) assessed with pressure myography. Collagen (Masson's Trichrome) and elastin (Verhoff) were visualized histologically and % positively-stained area was assessed. Median maternal age was 32 years (range 25-34) for younger, and 38 years (range 35-42) for women of advanced maternal age. Circumferential strain was lower in arteries from advanced maternal age versus younger women but circumferential stress was not different. Omental artery collagen levels were similar, while elastin levels were lower with advanced maternal age versus younger pregnancies. The collagen:elastin ratio was greater in arteries from advanced maternal age versus younger women. In conclusion, omental arteries from women of advanced maternal age were less compliant with less elastin compared with arteries of younger controls, which may affect how vascular stressors are tolerated during pregnancy. Understanding how vascular aging affects pregnancy adaptations may contribute to better pregnancy outcomes.

P-535 DNA methylation abnormalities induced by advanced maternal age in villi in early pregnancy prime a high-risk state for spontaneous abortion

Abstract Study question What’s the epigenetic effect of advanced maternal age (AMA, &amp;gt; =35 at delivery) on human villus in early pregnancy and its relationship with spontaneous abortion (SA)? Summary answer AMA-induced local changes in DNA methylome would perturb villous transcriptome and trophoblast cellular function, which may partly explain increased risk of SA in AMA pregnancy. What is known already The proportion of AMA in living births has increased in many countries over recent decades. However, AMA has been regarded as an independent risk factor for many pregnancy complications, including SA, which are closely associated with placental dysfunction in early pregnancy. Currently, researches about the epigenetic influence of AMA has been extremely limited, and only one study in mice tried to explore the DNA methylation alterations of eight ICRs in AMA placenta. The DNA methylation pattern of the human placenta in AMA pregnancy is still blank, and a comprehensive genome-wide investigation of AMA’s influence is urgently needed. Study design, size, duration We profiled the DNA methylome of 24 human chorionic villi samples (CVSs) from early pregnancies in AMA and young maternal age (YMA) and 11 CVSs from early spontaneous abortion cases, and the transcriptome of 10 CVSs from AMA and YMA pregnancies. Trophoblast cellular impairment were investigated by repressing target gene in trophoblast cell lineage. Participants/materials, setting, methods CVSs from early pregnancies were collected, the DNA methylome were profiled, using reduced representation bisulfite sequencing (RRBS), and the transcriptome were profiled. with mRNA sequencing(mRNA-seq). Single-cell villous transcriptional altas presented the expression patterns of targeted AMA-/SA-related genes. Cellular function experiment werewas performed after the knockdown of GNE expression in HTR8-S/Vneo cells. Main results and the role of chance AMA-induced local DNA methylation changes, defined as AMA-related differentially methylated regions (DMRs), might be derived from the abnormal expression of genes taking part in DNA demethylation, such as GADD45B. These DNA methylation changes were significantly enriched in the processes involved in Notch signaling and extracellular matrix organization, and reflected in the transcriptional alterations in the corresponding biological processes and specific genes, too. Furthermore, the DNA methylation level of special AMA-related DMRs not only significantly changed in AMA, but also showed more excessive defects in CVS from spontaneous abortion (SA), including four AMA-related DMRs whose nearby genes were overlapping AMA-related differentially expressed genes (DEGs) (CDK11A, C19orf71, COL5A1, and GNE). The decreased DNA methylation level of DMR near GNE was positively correlated with the downregulated expression of GNE in AMA. Single-cell altas further revealed the comparatively high expression of GNE in trophoblast lineage, and the knockdown of GNE in HTR8-S/Vneo cells significantly impaired cellular proliferation and migration. Our study provides valuable resources to investigate AMA-induced epigenetic abnormalities and bring a new insight for explaining the increased risks of pregnancy complications in AMA pregnancy. Limitations, reasons for caution The samples size was still small, a larger cohort study would be helpful to verify our findings in future. Meanwhile, though the high co-relationships between the expression of specific DEGs and the DNA methylation level of nearby DMRs, the detailed mechanisms in gene expression regulation need to be further explored. Wider implications of the findings It deepened our understanding of the influences of AMA and provided novel evidence to develop strategies for the diagnosis, providence and even therapy for pregnancy complications in AMA. Trial registration number not applicable

The Effect of Advanced Maternal Age on Adverse Outcomes Among Forceps-Assisted Vaginal Deliveries [ID: 1355950

INTRODUCTION: Delivery rates among patients of advanced maternal age (AMA) are increasing. Prior studies have shown that AMA is associated with increased pregnancy risks and adverse outcomes. This study’s objective was to evaluate whether AMA is associated with an increase in obstetric anal sphincter injury (OASIS) rates among patients who undergo forceps-assisted vaginal deliveries (FAVDs). METHODS: This was an IRB-approved, retrospective cohort study of singleton gestations with FAVD at a single institution between 2017 and 2021. Primary outcome was rate of OASIS among patients with and without AMA. Secondary outcomes included quantitative blood loss (QBL), neonatal composite of subgaleal and cephalohematoma (adverse neonatal composite), and neonatal intensive care unit (NICU) admission. Quantitative blood loss was assessed using Mann-Whitney U test. Remaining outcomes were assessed using multivariate logistic regression models while adjusting for provider clustering and confounding patient characteristics including episiotomy and birth weight. RESULTS: Nine hundred eighty-three records were included, 704 non-AMA and 279 AMA. Patients of AMA were more likely to be Caucasian and were less likely to be Hispanic, nulliparous, experience spontaneous labor, and undergo episiotomy. Patients of AMA did not demonstrate increased odds of OASIS compared to non-AMA patients (odds ratio [OR] 1.21 [0.78, 1.89]). When age was assessed continuously, there was no association between increasing age and rates of OASIS (OR 1.02 [0.98, 1.06]). There was no statistically significant difference in QBL among the two groups (357.0 versus 350.0 cc, P=.20), NICU admission or adverse neonatal composite. CONCLUSION: Advanced maternal age does not appear to be a risk factor for OASIS or other adverse outcomes in patients undergoing FAVD.

PD18-03 THE EFFECTS OF PARENTAL-AGE DIFFERENCES ON ADVERSE PERINATAL OUTCOMES

You have accessJournal of UrologyCME1 Apr 2023PD18-03 THE EFFECTS OF PARENTAL-AGE DIFFERENCES ON ADVERSE PERINATAL OUTCOMES Victor Yu, Joemy Ramsay, Joshua John Horns, and James Hotaling Victor YuVictor Yu More articles by this author , Joemy RamsayJoemy Ramsay More articles by this author , Joshua John HornsJoshua John Horns More articles by this author , and James HotalingJames Hotaling More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003273.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The effects of advanced maternal age on perinatal outcomes have been well-documented, with several studies demonstrating a significant risk for women over 35 years. Other studies have identified potential associations between advanced paternal age and adverse perinatal outcomes. This study aimed to expand upon such findings by assessing the risks associated with the tertiary variable of parental-age differences. METHODS: A retrospective cohort analysis was performed using data compiled from the National Vital Statistics System for 21,021,091 US births between 2012-2018. Logistic regression controlling for demographic and health-related covariates was used to assess odds of low birthweight, very low birthweight, preterm birth, very preterm birth, small size for gestational age, low 5-minute APGAR score, congenital defects, and chromosomal anomalies. RESULTS: Increased parental-age differences were associated with significant risks for all adverse outcomes, aside from congenital defects, even when controlling for maternal age. Restricting maternal age to the reference range of 25-29 years, infants born to fathers aged 5-8 years younger (n=87,032) had 19% (OR 1.19, 95% CI 1.17 – 1.21) higher odds of having any adverse perinatal outcome. Conversely, infants born to fathers aged >16 years older (n=100,971) had 11% (OR 1.11, 95% CI 1.09 – 1.13) higher odds of having any adverse perinatal outcome. CONCLUSIONS: Large differences in parental age are associated with adverse birth outcomes and exhibit a bimodal distribution. Older mothers paired with younger fathers had the highest risks, even when maternal age was below 35 years. Potential mechanisms as to why younger fathers may elevate outcome risks include sperm genetic or epigenetic instability, lower socioeconomic status, unstable social and familial environments, or precarious lifestyle factors associated with this age group. Clinically, parental-age differences should be considered alongside maternal and paternal age when assessing risks of adverse perinatal outcomes for potential parents. Source of Funding: NIH Ruth L. Kirschstein National Research Service Award (NRS) institutional training grant (T35DK103596) © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e503 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Victor Yu More articles by this author Joemy Ramsay More articles by this author Joshua John Horns More articles by this author James Hotaling More articles by this author Expand All Advertisement PDF downloadLoading ...

Effect of the interaction between advanced maternal age and pre-pregnancy BMI on pre-eclampsia and GDM in Central China

IntroductionTo investigate the independent and combined effects of advanced maternal age and pre-pregnancy body mass index (BMI) on the risk of pre-eclampsia and gestational diabetes mellitus (GDM).Research design and methodsLogistic...

The effects of advanced maternal age on perinatal mortality in Ethiopia: A systematic review and meta-analysis.

Pregnancy in women over the age of 35 years is considered advanced maternal age. The relationship between advanced maternal age and the risk of perinatal mortality is still controversial. As a result, this systematic review and meta-analysis were carried out to clarify the relationship between advanced maternal age and perinatal mortality in Ethiopia. The following electronic databases were used for this systematic review and meta-analysis: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, HINARI, and African Journals Online up to March 2022. Addis Ababa, Gondor, and Jimma University research repositories were also searched. A random-effects model was used to pool study-specific odds ratios. A total of 18 articles, including a total of 45,541 participants, were included in the meta-analysis. A total of 11 cross-sectional, 2 case-control, and 5 cohort studies were included. The overall pooled estimate indicates that women with advanced maternal age had a 1.58 higher risk of perinatal mortality compared to women in the younger age group (odds ratio = 1.58; 95% Confidence Interval: 1.13-2.03). The subgroup analysis also revealed that there were differences in the effect size as the geographical region differed. The result showed that the odd of perinatal mortality was highest in the Oromia region and lowest in the Southern Nations Nationalities and Peoples' Region. The overall pooled estimate indicates that women with advanced maternal age had a 1.58-fold higher risk of perinatal mortality. Even though this risk could also be increased with other comorbid diseases, it is important for healthcare providers and other concerned stakeholders to be aware of the increased risks associated with advanced maternal age and provide different intervention programs designed to create awareness and provide counseling services to couples who seek to have a child in their later ages about the risks of advanced maternal age pregnancy on perinatal mortality and other adverse pregnancy outcomes.

To Evaluate the Effect of Increasing Maternal Age on Maternal and Neonatal Outcomes in Pregnancies at Advanced Maternal Age.

Late pregnancies have been a sensitive issue in the society and medical field for many years. The reason for this development could be the increasing use of reproductive techniques, women empowerment and late conceptions. The increased level of education in women, having more responsibilities at work, giving priority to their professional career could be leading to delay in conception and childbearing. Many studies have investigated the effect of advanced maternal age on fetal outcome suggesting higher risk of poor neonatal outcome. Recent studies have debated these outcomes.[1234]. To evaluate the effect of increasing maternal age on maternal and neonatal outcomes in pregnancies at advanced maternal age. The study was conducted on 843 women above the age of 35 years who delivered at Dayanand Medical College and Hospital during 2015-2020. Patients were categorized into 2 groups, Group A comprised of pregnant women aged 35-40 years; group B included pregnant women aged >40 years. Various other parameters including parity, gestation at delivery, whether the pregnancies were spontaneous or conceived through ART (assisted reproductive techniques) and other associated co-morbid conditions were noted. The obstetrical, gynecological, medical, surgical, fetal and neonatal complications were studied in both the groups and the data was analyzed with release 9.4 (SAS Institute Inc, Cary, NC). Out of 843 patients in our study, 81.4% (n=687) belonged to the age group of 35- 40 years. 18.5% (n=156) belonged to the age group of > 40 years. Patients more than 40 years underwent ART for conception more often as compared to group A. Co-morbid medical conditions including chronic hypertension, thyroid diseases, auto immune disorders and obstetric complications such as abortions, oligohydramnios, GDM, placenta previa, PPH was significantly more common in patients with group B. Cesarean delivery rate was significantly more in group B as compared to group A. Neonatal outcome in terms of NICU admissions and preterm birth at less than 35 weeks gestation was seen more frequently in group B as compared to Group A. Our study concludes that the decision to delay childbearing should be discouraged owing to increased maternal and fetal morbidity associated with advanced maternal age, the risks being higher with increasing maternal age.

Risk of morbidity and mortality in preterm infants born to advanced maternal age pregnancies

Background: Little is known about the effect of advanced maternal age on preterm morbidity and mortality. This study aimed to evaluate the possible relationship between maternal age and morbidity and mortality in premature infants born at a gestational age ≤32 weeks.Methods: Premature infants born at ≤32 weeks of gestation and admitted to the neonatal intensive care unit were divided into three groups by maternal age: &amp;lt;35, 35-39, and ≥40 years. Infant and maternal demographic and clinical characteristics, and preterm morbidity and mortality were compared between the groups.Results: A total of 827 preterm infants were included. Their distribution by maternal age was as follows: 659 infants in the &amp;lt;35 years group, 120 in the 35-39 years group, and 48 in the ≥40 years age group. Older maternal age was associated with higher gravidity, frequency of assisted reproductive technology use, preeclampsia, gestational diabetes mellitus, and caesarean delivery (P=0.004, P&amp;lt;0.001, P=0.007, P=0.004, and P&amp;lt;0.001, respectively). Respiratory distress syndrome, patent ductus arteriosus, and necrotising enterocolitis were significantly more frequent in preterm infants aged ≥35 years (P=0.014, P=0.029, and P&amp;lt;0.001, respectively).Conclusions: In addition to the maternal risks associated with pregnancy at older ages, some prematurity morbidities may also increase in frequency. Although this novel study presents important results, further studies are needed to evaluate the relationship between advanced maternal age and preterm morbidity.

Do Hypertensive Disorders of Pregnancy and Abnormal Placentation Mediate the Association between Advanced Maternal Age and Adverse Perinatal Outcomes?

A tertiary-hospital-based retrospective study (2011-2019) was conducted to determine the mediating role of hypertensive disorders of pregnancy and abnormal placentations between advanced maternal age and adverse neonatal outcomes. Data from a tertiary-hospital-based retrospective study (n= 23051) was used and conducted regression-based mediation analysis to assess the mediating role of hypertensive disorders of pregnancy and abnormal placentation between the advanced maternal age and adverse neonatal outcomes. After adjusting for confounding factors, the indirect effect of advanced maternal age on preterm births, perinatal mortality, and low birth weight mediated by hypertensive disorders of pregnancy was [aOR 4.95 (95% CI: 4.05, 5.85)], [aOR 2.82 (95% CI: 1.78, 3.86)], and [aOR 5.90 (95% CI: 4.93, 6.87)], respectively. The indirect effect of advanced maternal age on preterm births and low birth weight mediated by abnormal placentation was [aOR 6.83 (95% CI: 5.70, 7.97)] and [aOR 4.18 (95% CI: 3.26, 5.11)]. About, 23%, 37%, and 17% of the effect of advanced maternal age on preterm births, perinatal mortality, and low birth weight was mediated by hypertensive disorders of pregnancy, respectively. Furthermore, abnormal placentation mediates the association between advanced maternal age and preterm births by 18% and low birth weight by 23%. Hypertensive disorders of pregnancy and abnormal placentation partially mediate the association between advanced maternal age and adverse neonatal outcomes.

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.

Effect of Advanced Maternal Age on Prenatal Attachment

Effect of Advanced Maternal Age on Prenatal Attachment

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.

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.

Effect of advanced maternal age on pregnancy outcome - A retrospective cohort study

To determine the risks of pregnancy and to study the adverse maternal and fetal outcomes of pregnancy in advanced maternal age.This study was a retrospective cohort study. Which was conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode. Data were collected from Department Medical Records Library. Data consisted of study group with maternal age above 35 years and control group with age less than 35 years. Cases beyond 28 weeks of gestation, both primiparous and multiparous patients were included. Minimum 262 patients were included in each group. Gestational age, presentation, mode of delivery, indications for caesarean, maternal complications and fetal outcomes were analysed. Statistical analysis was done by SPSS16.0 statistical software. In this study statistically significant difference in maternal complications like incidence of gestational diabetes, gestational hypertension and preterm labour were observed in advanced maternal age women.Increasing incidence of maternal complications both obstetric and medical were observed in the advanced age mothers (AMA). There was a significant increase in preterm labour, increased caesarean delivery, PROM, PPROM, gestational hypertension, gestational diabetes, VLBW babies, intrauterine death in these elderly mothers. Due to the increase and advances of infertility treatments has made it common for mothers to become pregnant even at late forties.