Role Of Maternal Age Research Articles

Role of Maternal Age in Fiscal Analysis: The Case of Germany

Role of Maternal Age in Fiscal Analysis: The Case of Germany

Role of Maternal Age in Increasing Severe Maternal Morbidity Rates in the United States.

To evaluate a commonly proposed explanation for increasing rates of severe maternal morbidity (SMM) in the United States: shifts in the birthing population to older maternal ages, a known risk factor for SMM. We conducted a cross-sectional analysis comparing delivery hospitalizations from two time points (2008-2009 to 2017-2018) using hospital discharge data from the National Inpatient Sample. We used demographic decomposition techniques to evaluate whether increasing rates of SMM and nontransfusion SMM were explained by population-level increases in maternal age or changes in age-specific rates. Analyses were stratified by race and ethnicity. Rates of SMM and nontransfusion SMM significantly increased in the United States between 2008 and 2018 from 135.6 to 170.5 and 58.8 to 67.9 per 10,000 delivery hospitalizations, respectively, with increases observed for nearly all racial and ethnic groups. Over this same period, the proportion of births to people younger than age 25 years decreased and births to people of advanced maternal age (35 years and older) increased, with the largest increases occurring among people identified as non-Hispanic American Indian/Alaskan Native (9.8-13.0%), non-Hispanic Black (10.7-14.4%), and Hispanic (12.1-17.1%). Decomposition analyses indicated that the changing maternal age distribution had little effect on SMM trends. Rather, increases in SMM and nontransfusion SMM were primarily driven by increases in age-specific SMM rates, including rising rates among younger people. Contributions of maternal age shifts were minimal for all racial and ethnic groups except among non-Hispanic Black people, for which 17-34% of the rise in SMM was due to increasing maternal age. Except among certain racial groups, increases in U.S. population-level SMM rates over the past decade were due to increases in age-specific rates rather than shifts to older maternal age among the birthing population. Increasing SMM rates across the maternal age spectrum could indicate worsening prepregnancy health status of the birthing population.

Maternal age is highly associated with non-chromosomal congenital anomalies: Analysis of a population-based case-control database.

The role of maternal age in the development of non-chromosomal congenital anomalies (NCAs) is under debate. Therefore, the primary aim of this study was to identify the age groups at risk for NCAs. The secondary aim was to perform a detailed analysis of the relative frequency of various anomalies. National population-based study. The Hungarian Case-Control Surveillance of Congenital Anomalies (CAs) between 1980 and 2009. A cohort of 31 128 cases with confirmed NCAs was compared with Hungary's total of 2 808 345 live births. Clinicians prospectively reported cases after delivery. Data were analysed by non-linear logistic regression. Risk-increasing effect of young and advanced maternal age was determined by each NCA group. These were the total number of NCAs: cleft lip and palate, circulatory, genital, musculoskeletal, digestive, urinary, eye, ear, face, and neck, nervous system, and respiratory system anomalies. The occurrence of NCAs in our database was lowest between 23 and 32 years of maternal age at childbirth. The relative risk (RR) of any NCA was 1.2 (95% CI 1.17-1.23) and 1.15 (95% CI 1.11-1.19) in the very young and advanced age groups, respectively. The respective results for the circulatory system were RR=1.07 (95% CI 1.01-1.13) and RR=1.33 (95% CI 1.24-1.42); for cleft lip and palate RR=1.09 (95% CI 1.01-1.19) and RR=1.45 (95% CI 1.26-1.67); for genital organs RR=1.15 (95% CI 1.08-1.22) and RR=1.16 (95% CI 1.04-1.29); for the musculoskeletal system RR=1.17 (95% CI 1.12-1.23) and RR=1.29 (95% CI 1.14-1.44); and for the digestive system RR=1.23 (95% CI 1.14-1.31) and RR=1.16 (95% CI 1.04-1.29). Very young and advanced maternal ages are associated with different types of NCAs. Therefore, screening protocols should be adjusted for these risk groups.

The role of maternal age & birth order on the development of unilateral and bilateral retinoblastoma: a multicentre study

Background/ObjectivesRetinoblastoma is a common childhood intraocular malignancy, the bilateral form of which most commonly results from a de novo germline pathogenic variant in the RB1 gene. Both advanced maternal age and decreasing birth order are known to increase the risk of de novo germline pathogenic variants, while the influence of national wealth is understudied. This cohort study aimed to retrospectively observe whether these factors influence the ratio of bilateral retinoblastoma cases compared to unilateral retinoblastoma, thereby inferring an influence on the development of de novo germline pathogenic variants in RB1.Subjects/MethodsData from 688 patients from 11 centres in 10 countries were analysed using a series of statistical methods.ResultsNo associations were found between advanced maternal age, birth order or GDP per capita and the ratio of bilateral to unilateral retinoblastoma cases (p values = 0.534, 0.201, 0.067, respectively), indicating that these factors do not contribute to the development of a de novo pathogenic variant.ConclusionsDespite a lack of a definitive control group and genetic testing, this study demonstrates that advanced maternal age, birth order or GDP per capita do not influence the risk of developing a bilateral retinoblastoma.

The role of maternal age, growth, and environment in shaping offspring performance in an aerial conifer seed bank.

Maternal effects have been demonstrated to affect offspring performance in many organisms, and in plants, seeds are important mediators of these effects. Some woody plant species maintain long-lasting canopy seed banks as an adaptation to wildfires. Importantly, these seeds stored in serotinous cones are produced by the mother plant under varying ontogenetic and physiological conditions. We sampled the canopy seed bank of a highly serotinous population of Pinus pinaster to test whether maternal age and growth and the environmental conditions during each crop year affected seed mass and ultimately germination and early survival. After determining retrospectively the year of each seed cohort, we followed germination and early survival in a semi-natural common garden. Seed mass was related to maternal age and growth at the time of seed production; i.e., slow-growing, older mothers had smaller seeds, and fast-growing, young mothers had larger seeds, which could be interpreted either as a proxy of senescence or as a maternal strategy. Seed mass had a positive effect on germination success, but aside from differences in seed mass, maternal age had a negative effect and diameter had a positive effect on germination timing and subsequent survival. The results highlight the importance of maternal conditions combined with seed mass in shaping seedling establishment. Our findings open new insights in the offspring performance deriving from long-term canopy seed banks, which may have high relevance for plant adaptation.

Incidence of preterm births in a referral teaching hospital in Ghana: What is the role of maternal age, parity, gravidity and stress during pregnancy?

Background. Preterm births (PTBs) notably contribute to neonatal morbidity and mortality in neonatal intensive care units (NICUs). Therefore, an examination of maternal risk factors is essential in reducing the incidence of PTB. Objective. To estimate maternal risk factors of PTBs with subsequent admission to the NICU. Methods. We interviewed 357 mothers who gave birth at the Korle-Bu Teaching Hospital (KBTH) and their neonates admitted to the hospital’s NICU. A binary multivariate logistic regression model was used to analyse the odds ratios of each predictor variable. Results. The incidence of PTBs associated with admission to the NICU was 70%. From our estimation model, maternal parity emerged as the single most influential risk factor of preterm neonates who subsequently had to be admitted to the NICU, contributing to a significant 17.3% of the model fit compared with 12.9% for maternal stress and 1% for maternal age. Approximately 35% of the mothers did not attend the minimum number of antenatal care (ANC) visits (four) recommended by the Ghana Ministry of Health, which may have increased their risk of PTB. Conclusion. The most appropriate intervention to reduce the high risk of PTB is for expectant mothers to attend ANC during their pregnancy. Health professionals rendering ANC services should also educate mothers on how to avoid or manage stress during pregnancy to reduce the incidence of PTB.

Pregnancy and neonatal outcomes of twin pregnancies- the role of maternal age.

We aim to study the association of maternal age with maternal and neonatal complications in twin pregnancies. A retrospective cohort study of dichorionic-diamniotic twin pregnancies stratified into three groups according to maternal age ("A" <25, "B" 25-34 and "C" 35-44 years old). Outcome measures included pregnancy, delivery and neonatal complications. A sub-analysis of in vitro fertilization pregnancies only was conducted. Compared with younger women (groups A [n=65] and B [n=783]), older women [group C (n=392)] demonstrated significantly higher rates of gestational diabetes mellitus (B 6.6% vs. A 0%, p =0.027, C 10.2% vs. B 6.6%, p =0.032), were more likely to undergo cesarean deliveries (C 66.6%, B 57.6%, A 52.3%, p =0.007), and were at increased risk of having more than 20% difference in weight between the twins (C 24.5%, B 17.4%, A 16.9%, p =0.013). Other outcomes, including preeclampsia, did not differ between the groups. A sub-analysis of the in vitro fertilization only pregnancies was performed. Compared with younger women (groups A [n=18] and B [n=388]), older women (group C [n=230]) underwent more cesarean deliveries (p=0.004), and had more than 20% difference in weight between the twins (p<0.004). Other outcomes, including gestational diabetes mellitus rates and preeclampsia, did not differ between the groups. Women at advanced maternal age with dichorionic twin pregnancies had significantly higher rates of gestational diabetes mellitus, cesarean deliveries and fetal weight discordancy as compared with younger women. In contrast, the incidence of preeclampsia was not affected by maternal age.

Maternal age at delivery and risk of allergy and asthma in the offspring: a systematic review and meta-analysis protocol

IntroductionWhile several perinatal factors have been linked to the risk of developing asthma and allergy in childhood, the role of maternal age at delivery remains uncertain. Some studies suggest that...

Role of Maternal Age and Pregnancy History in Risk of Miscarriage: Prospective Register-based Study

(BMJ. 2019;364:I869) Miscarriage is unfortunately a relatively common pregnancy outcome. Various studies have reported that 12% to 15% of pregnancies end in miscarriage. However, these rates may not be accurate as some women experience miscarriage without ever realizing they were pregnant and differences exist among studies regarding the definition of miscarriage versus stillbirth. Several risk factors for miscarriage have been reported, but maternal age seems to have the strongest association. The youngest mothers have a slightly increased risk while older women have a much greater risk than younger women. There might also be an association between previous pregnancy complications and miscarriage risk. This population-based study aimed to evaluate the rate of miscarriage and its association with maternal age and pregnancy history among Norwegian women.

Role of maternal age at birth in child development among Indigenous and non-Indigenous Australian children in their first school year: a population-based cohort study

Indigenous Australian children are twice as likely to score poorly on developmental outcomes at age 5 years than their non-Indigenous peers. Indigenous children are also more likely to be born to younger mothers. We aimed to quantify the relationship between maternal age at childbirth and early childhood development outcomes in Indigenous and non-Indigenous children. In this population-based, retrospective cohort study, we used data from the Australian Early Development Census (AEDC) that were probabilistically linked by the New South Wales (NSW) Centre for Health Record Linkage to several NSW administrative datasets, including the Perinatal Data Collection, the Register of Births, Deaths and Marriages (for birth registrations), the Admitted Patient Data Collection, and public school enrolment records, as part of the Seeding Success study. The resulting data resource comprises a cohort of 166 278 children born in NSW whose first year of school was reported in a 2009 or 2012 AEDC record (which were the years of AEDC data available at the time of data linkage). The primary outcome was the aggregate outcome of developmental vulnerability (scores in the bottom decile, according to the 2009 benchmark, on one or more of the five AEDC domains, which include physical, social, emotional, language and cognitive, and communication development). This outcome was measured in singleton children without special needs recorded on the AEDC, in those with available developmental data. As a secondary outcome analysis, we also repeated the main analyses on the outcome of developmental vulnerability on the individual domains. We estimated the absolute risk of developmental vulnerability by maternal age in Indigenous and non-Indigenous populations, and we also estimated the risk difference and relative risk between Indigenous and non-Indigenous children by use of modified Poisson regression. Of 166 278 children in the cohort, 107 666 (64·8%) children were enrolled in a public school in NSW in 2009 or 2012, of whom 7994 (7·4%) children were Indigenous (ie, they, or either parent, were recorded as Aboriginal or Torres Strait Islander on one or more birth records) and 99 672 (92·6%) children were not Indigenous. After exclusions, the final study population included 99 530 children (7206 [7·2%] Indigenous and 92 324 [92·8%] non-Indigenous). Of those for whom developmental outcome data were available, 2581 (35·9%) of 7180 Indigenous children and 18 071 (19·7%) of 91 835 non-Indigenous children were developmentally vulnerable on one domain or more. The risk of developmental vulnerability decreased with maternal ages between 15 and 39 years, but the decrease in risk with maternal age was significantly steeper in non-Indigenous than Indigenous children. Developmental vulnerability is most common in Indigenous and non-Indigenous children born to young mothers; however, Indigenous children have an increased risk of this outcome across most of the maternal age range. Policies that improve the socioeconomic circumstances of Indigenous children and families could promote better developmental outcomes among Indigenous children. Culturally appropriate support for Indigenous children, including those born to young mothers and disadvantaged families, could also reduce early childhood developmental inequalities. The Australian National Health and Medical Research Council, Manitoba Centre for Health Policy.

Advanced maternal age and the impact on maternal and offspring cardiovascular health.

Delaying pregnancy, which is on the rise, may increase the risk of cardiovascular disease in both women and their children. The physiological mechanisms that lead to these effects are not fully understood but may involve inadequate adaptations of the maternal cardiovascular system to pregnancy. Indeed, there is abundant evidence in the literature that a fetus developing in a suboptimal in utero environment (such as in pregnancies complicated by fetal growth restriction, preterm birth, and/or preeclampsia) is at an increased risk of cardiovascular disease in adulthood, the developmental origins of health and disease theory. Although women of advanced age are at a significantly increased risk of pregnancy complications, there is limited information as to whether advanced maternal age constitutes an added stressor on the prenatal environment of the fetus, and whether or not this is secondary to impaired cardiovascular function during pregnancy. This review summarizes the current literature available on the impact of advanced maternal age on cardiovascular adaptations to pregnancy and the role of maternal age on long-term health risks for both the mother and offspring.

Risk of severe maternal morbidity associated with cesarean delivery and the role of maternal age: a population-based propensity score analysis.

Short-term maternal complications of cesarean delivery remain uncertain because of confounding by indication. Our objective was to assess whether cesarean delivery is associated with severe acute intra- or postpartum maternal morbidity compared with vaginal delivery, overall and according to the timing of the cesarean. We performed a case-control analysis using data from EPIMOMS, a prospective population-based study of deliveries at 22 gestation weeks or later from 6 regions of France in 2012-2013. Cases of intra- or postpartum severe acute maternal morbidity that were not a result of a condition present before delivery were compared with controls randomly selected in a 1/50 ratio. Associations between delivery modes and severe acute maternal morbidity were estimated in a propensity score-matched sample. Among 182 300 deliveries, we identified 1444 cases and 3464 controls. The proportion of cesarean delivery was significantly higher among cases than controls (36.0% v. 18.2%). In the propensity score-matched analysis, cesarean deliveries were significantly associated with a higher risk of severe acute maternal morbidity (adjusted odds ratio [OR] 1.8, 95% confidence interval [CI] 1.5-2.2). This association increased with maternal age and was particularly marked for women aged 35 years or older (adjusted OR 2.9, 95% CI 1.9-4.4). This increased risk was significant for cesarean deliveries during labour in women of all age groups and for those before labour only in women aged 35 years or older (adjusted OR 5.1, 95% CI 2.3-11.0). Cesarean delivery is associated with a higher risk of severe acute maternal morbidity than vaginal delivery, particularly in women aged 35 years and older. Clinical decisions regarding delivery mode should account for this excess risk accordingly.

Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study

ObjectivesTo estimate the burden of miscarriage in the Norwegian population and to evaluate the associations with maternal age and pregnancy history.DesignProspective register based study.SettingMedical Birth Register of Norway, the Norwegian...

Risk Factors for Pregnancy-Associated Venous Thromboembolism: The Role of Maternal Age, Obesity, Smoking and Other Modifiable Risk Factors

INTRODUCTION: Pregnancy is a risk factor for venous thromboembolism (VTE) and VTE affects 1 in 500 to 1 in 2000 pregnancies. Up to 30-50% of women with pregnancy-associated VTE may have an inherited thrombophilia but this does not completely explain the thrombosis risk. Clinical risk factors for VTE including multiple births, inflammatory bowel disease, sickle cell disease, diabetes, increased maternal age, stillbirth, and smoking have been identified in relatively small cohorts. We conducted this large case-control study to identify patient and pregnancy-associated risk factors for VTE during pregnancy or within 6 weeks post-partum.METHODS: The study population was drawn from the Vanderbilt University Medical Center bio-repository (BioVU) that includes de-identified clinical data and DNA samples (from 2007 to 2017). We used a phenotyping algorithm using ICD9 and ICD10 diagnosis codes for pregnancy and venous thromboembolism, as well as procedure codes for pregnancy-related procedures to identify women with VTE during pregnancy or within 6 weeks following delivery (cases), and age matched pregnant women without any history of VTE (controls). Subsequently, manual review of all patients identified by the phenotyping algorithm was performed to confirm case status. Initially, 2 controls per case we identified; however 21 (of 272) cases were reclassified as controls on manual review. Data regarding demographic variables, body mass index (BMI), smoking and comorbidities potentially impacting VTE risk (diabetes, gestational diabetes, multiple pregnancy, eclampsia, preclampsia, HELLP syndrome) was extracted using diagnosis codes. Multivariable logistic regression was used to identify associations with pregnancy-associated VTE.RESULTS: The study population comprised 816 individuals including 251 women with pregnancy-associated VTE and 565 controls; 52.3% were Caucasian, 40.3% were African American, and 7.4% comprised other races. Mean age at index pregnancy was 28.2 ± 7.4 years. A pre-pregnancy diagnosis of chronic hypertension affected 6.37%, diabetes mellitus affected 6.13%, and 2.82% reported smoking during or within 6 weeks of pregnancy (Table 1). Multiple gestation, preeclampsia/eclampsia, gestational diabetes, and HELLP syndrome affected 3.06%, 10.54%, 4.66%, and 1.35% of pregnancies, respectively. Thrombophilia was diagnosed in 20 women with pregnancy-associated VTE (8 antiphospholipid syndrome [APS], 4 protein S deficiency, 1 protein C deficiency, 4 factor V Leiden [FVL] heterozygotes and 1 each with FVL with APS and FVL with protein C deficiency). However, thrombophilia evaluation was not performed consistently and thus was not included in the final multivariable analysis.In a multivariable logistic regression model (Figure 1), age at pregnancy (odds ratio [OR] 1.06 [95% CI 1.03-1.08], P<0.001), smoking (OR 2.94 [95% CI 1.18-7.31], P=0.020), chronic hypertension (OR 4.55 [95% CI 2.32-8.95], P<0.001), BMI (OR 1.93 [95% CI 1.27-2.94], P = 0.002 for BMI 25-30 kg/m2; OR 2.50 [95% CI 1.67-3.75], P<0.001 for BMI >35 with a BMI of 18.5-25 as the reference category), and African American race (OR 2.21 [95% CI 1.55-3.16], P<0.001) were associated with pregnancy-associated VTE. Preeclampsia/eclampsia (OR 1.05 [0.60-1.84], P=0.856), multiple gestation (OR 1.74 [95% CI 0.73-4.14], P=0.211), HELLP (OR 0.30 [95% CI 0.06-1.66], P=0.169), gestational diabetes (OR 1.02 [95% CI 0.47-2.18], P=0.968), and delivery by cesarean section (OR 1.32 [95% CI 0.95-1.84], P=0.099) were not significant risk factors for pregnancy-associated VTE.CONCLUSION: This large case-control study demonstrates that modifiable factors such as maternal obesity, smoking and chronic hypertension are important risk factors for pregnancy-associated VTE along with increasing maternal age and African American race. Addressing modifiable risk factors prior to conception may reduce the risk of pregnancy-associated VTE. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

The role of maternal age and context-dependent maternal effects in the offspring provisioning of a long-lived marine teleost.

Despite evidence of maternal age effects in a number of teleost species, there have been challenges to the assertion that maternal age intrinsically influences offspring quality. From an evolutionary perspective, maternal age effects result in young females paradoxically investing in less fit offspring despite a greater potential fitness benefit that might be gained by allocating this energy to individual somatic growth. Although a narrow range of conditions could lead to a maternal fitness benefit via the production of lower quality offspring, evolutionary theorists suggest these conditions are seldom met and that the reported maternal age effects are more likely products of the environmental context. Our goal was to determine if maternal effects operated on offspring provisioning in a long-lived rockfish (genus Sebastes), and to evaluate any such effects as an intrinsic function of maternal age or a context-dependent effect of the offspring release environment. We found that offspring provisioning is a function of both maternal age and the timing of offspring release; older females exhibit increased provisioning over younger females throughout the spawning season despite a decrease in provisioning across all maternal ages as the season progresses. These findings suggest a role for both maternal age effects and a potential context-dependent maternal effect in population productivity, carrying important implications when modelling population persistence and resilience.

The role of maternal age in twin pregnancy outcomes

There are limited data on how maternal age is related to twin pregnancy outcomes. The purpose of this study was to assess the relationship between maternal age and risk for preterm birth, fetal death, and neonatal death in the setting of twin pregnancy. This population-based study of US birth, fetal death, and period-linked birth-infant death files from 2007-2013 evaluated neonatal outcomes for twin pregnancies. Maternal age was categorized as 15-17, 18-24, 25-29, 30-34, 35-39, and ≥40 years of age. Twin live births and fetal death delivered at 20-42 weeks were included. Primary outcomes included preterm birth (<34 weeks and <37 weeks), fetal death, and neonatal death at <28 days of life. Analyses of preterm birth at <34 and <37 weeks were adjusted for demographic and medical factors, with maternal age modeled with the use of restricted spline transformations. A total of 955,882 twin live births from 2007-2013 were included in the analysis. Preterm birth rates at <34 and <37 weeks gestation were highest for women 15-17 years of age, decreased across subsequent maternal age categories, nadired for women 35-39 years old, and then increased slightly for women ≥40 years old. Risk for fetal death generally decreased across maternal age categories. Risk for fetal death was 39.9 per 1000 live births for women 15-17 years old, 24.2 for women 18-24 years old, 17.8 for women 25-29 years old, 16.4 for women 30-34 years old, 17.2 forwomen 35-39 years old, and 15.8 for women ≥40 years old. Risk forneonatal death at <28 days was highest for neonates born to women 15-17 years old (10.0 per 1,000 live births), decreased to 7.3 for women 18-24 years old and 5.5 for women 25-29 years old and ranged from 4.3-4.6 for all subsequent maternal age categories. In adjusted models, risk for preterm birth at <34-<37 weeks gestation was not elevated for women in their mid-to-late 30s; however, risk was elevated for women <20 years old and increased progressively with age for women in their 40s. Although twin pregnancy is associated with increased risk for most adverse perinatal outcomes, this analysis did not find advanced maternal age to be an additional risk factor for fetal death and infant death. Preterm birth risk was relatively low for women in their late 30s. Risks for adverse outcomes were higher among younger women; further research is indicated to improve outcomes for this demographic group. It may be reasonable to counsel women in their 30s that their age is not a major additional risk factor for adverse obstetric outcomes in the setting of twin pregnancy.

Twin pregnancies after assisted reproductive technologies: the role of maternal age on pregnancy outcome

ObjectivesOur aim was to investigate whether advanced maternal age (≥40years) still impairs the outcome of twin pregnancies after assisted reproductive techniques (ART). Study designThe retrospective observational study evaluated 430 nulliparous dichorionic diamniotic twin pregnancies conceived with ART. The population was divided into women <40 years old (Group A, n=265) and ≥40 years old (Group B, n=165). ResultsGestational diabetes mellitus and gestational hypertension/preeclampsia were significantly more frequent in nulliparous twin pregnancies after ART ≥40years compared to <40years (p=0.021 and p<0.001, respectively). In univariate analysis of twin pregnancies after ART, there was only a trend of higher incidence of total preterm birth (PB) rate within mother aged ≥40 years old (p=0.104). However, Group A showed higher rate of spontaneous preterm birth (SPB) <37 weeks, whereas Group B showed significantly higher rate of iatrogenic PB <37 weeks of gestation (p=0.023 and p=0.001, respectively). For delivery <32 weeks of gestation, the rate of SPB in Group A was significantly higher (p=0.002). A higher incidence of PB was observed in Group B after heterologous treatment (p<0.001). Despite this, the absolute prevalence of PB in the entire population is higher in Group A, both after autologous (22.5%) and heterologous (25%) ART treatment, than in Group B (10.1% vs 21.4%). ConclusionsOur data indicate that nulliparous twin pregnancies conceived with ART in mothers ≥40 years old did not show significantly higher incidence of PB, even if an increased rate of iatrogenic PB <37 weeks is showed.

Trends in alcohol consumption during pregnancy in Australia, 2001–2010

Callinan, S., &amp; Ferris, J. (2014). Trends in alcohol consumption during pregnancy in Australia, 2001–2010. The International Journal Of Alcohol And Drug Research, 3(1), 17-24. doi:10.7895/ijadr.v3i1.108Aim: The aim of the current study is to examine, using cross-sectional data, the role of maternal age, period (year of pregnancy) and cohort (year of birth) as predictors of alcohol consumption during pregnancy over a 10-year period.Design: Four cross-sectional surveys were examined, both separately and together.Setting: Using cross-sectional data, there does appear to be a positive relationship between maternal age and alcohol consumption during pregnancy; however, within any one survey period, it is difficult to determine if these patterns are due to period or cohort effects.Participants: The National Drug Strategy Household Survey (NDSHS) is a large-scale survey administered to more than 20,000 respondents. Across four survey periods, 3,281 women reported being pregnant in the 12 months prior to the survey.Measures: The section on pregnancy and alcohol in the NDSHS 2001, 2004, 2007 and 2010.Findings: Age was a significant positive predictor of alcohol consumption during pregnancy in 2010. However, when the four data sets were combined, period appeared to be a stronger predictor, with younger groups and cohorts decreasing consumption at a faster rate over time than older groups and cohorts.Conclusions: Although age and cohort do play a role in the likelihood of alcohol consumption among Australian women during pregnancy, period is the most important predictor, indicating that alcohol consumption among pregnant women is decreasing. Furthermore, knowledge of pregnancy results in a marked decrease in consumption, suggesting a possible focus for prevention campaigns.

Potential Contributors to the Canadian Pediatric Obesity Epidemic

As a group, Canadian children and youth are heavier than at any time in the recent past. However, to date there has been no critical examination of the factors which are likely to have contributed to these deleterious trends. A review of the evidence suggests that there is robust evidence supporting the role of reduced sleep, increased sedentary time, increased consumption of sugar-sweetened beverages, and secular increases in adult obesity as contributing factors to the current epidemic of childhood obesity. There is moderate evidence that these trends are related to changes in either total energy intake or physical activity, while there is very little evidence supporting the role of maternal age, breastfeeding, exposure to endocrine disrupters, or inadequate calcium intake. These findings suggest that targeting sleep, sedentary time, and sugar-sweetened beverage intake in Canadian children and youth may help to prevent future weight gain at the population level.

The role of maternal age and episiotomy in the risk of anal sphincter tears during childbirth

Many women who experience anal sphincter tear will suffer from anal incontinence. The most important tool to avoid this is to recognise the obstetric risk factors involved and thereby prevent injury. The aim of this study was to analyse and evaluate the risk factors of anal sphincter tear during delivery. Of a total of 57,943 vaginal deliveries, we identified 565 women with partial or total rupture of the anal sphincter and compared these women with 565 controls without sphincter tear with respect to possible risk factors. Several factors were significantly associated with sphincter tears, including nulliparity, birthweight, instrumental delivery, episiotomy, malpresentation, maternal age and epidural analgesia. The importance of these variables was further confirmed in a stepwise logistic regression analysis. Age was found to be a significant risk factor only when the birthweight was less than 4000 g. Episiotomy more than doubled the risk of sphincter tear when delivery was non-instrumental. There are several independent risk factors that should be considered when making decisions regarding delivery mode. Maternal age and episiotomy in non-instrumental delivery are two of these.