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Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

Author(s): Reza Omani-Samani, Saman Maroufizadeh, Nafise Saedi, Nasim Shokouhi, Arezoo Esmailzadeh, Mahdi Sepidarkish, Saeid Safiri and Amir Almasi-Hashiani*

Volume 18, Issue 3, 2022

Published on: 09 October, 2020

Article ID: e111021186774 Pages: 5

DOI: 10.2174/1573404816999201009160848

Price: $65

Abstract

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia.

Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women.

Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, participated in the study in 2015. The required data were gathered from hospitals which had the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interesting outcomes.

Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with a higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28-2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia, but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736).

Conclusion: Advanced maternal age is associated with a higher risk of unintended pregnancy, preterm birth and cesarean section, but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

Keywords: Advanced maternal age, unwanted pregnancy, preeclampsia, premature birth, cesarean section, low birth weight, Iran.

Graphical Abstract

[1]
Laopaiboon M, Lumbiganon P, Intarut N, et al. WHO multicountry survey on maternal newborn health research network. Advanced maternal age and pregnancy outcomes: A multicountry assessment. BJOG 2014; 121(Suppl. 1): 49-56.
[http://dx.doi.org/10.1111/1471-0528.12659] [PMID: 24641535]
[2]
Sauer MV. Reproduction at an advanced maternal age and maternal health. Fertil Steril 2015; 103(5): 1136-43.
[http://dx.doi.org/10.1016/j.fertnstert.2015.03.004] [PMID: 25934599]
[3]
Fitzpatrick KE, Tuffnell D, Kurinczuk JJ, Knight M. Pregnancy at very advanced maternal age: A UK population-based cohort study. BJOG 2017; 124(7): 1097-106.
[http://dx.doi.org/10.1111/1471-0528.14269] [PMID: 27581343]
[4]
Goisis A, Remes H, Barclay K, Martikainen P, Myrskylä M. Advanced maternal age and the risk of low birth weight and preterm delivery: A within-family analysis using Finnish population registers. Am J Epidemiol 2017; 186(11): 1219-26.
[http://dx.doi.org/10.1093/aje/kwx177] [PMID: 29206985]
[5]
Jackson S, Hong C, Wang ET, Alexander C, Gregory KD, Pisarska MD. Pregnancy outcomes in very advanced maternal age pregnancies: The impact of assisted reproductive technology. Fertil Steril 2015; 103(1): 76-80.
[http://dx.doi.org/10.1016/j.fertnstert.2014.09.037] [PMID: 25450294]
[6]
Ogawa K, Urayama KY, Tanigaki S, et al. Association between very advanced maternal age and adverse pregnancy outcomes: A cross sectional Japanese study. BMC Pregnancy Childbirth 2017; 17(1): 349.
[http://dx.doi.org/10.1186/s12884-017-1540-0] [PMID: 29017467]
[7]
Waldenström U, Cnattingius S, Vixner L, Norman M. Advanced maternal age increases the risk of very preterm birth, irrespective of parity: A population-based register study. BJOG 2017; 124(8): 1235-44.
[http://dx.doi.org/10.1111/1471-0528.14368] [PMID: 27770495]
[8]
Martin JA, Hamilton BE, Ventura SJ, Osterman MJ, Mathews TJ. Births: final data for 2011. Natl Vital Stat Rap 2013; 62(1): 1-69, 72.
[9]
Wang Y, Tanbo T, Abyholm T, Henriksen T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet 2011; 284(1): 31-7.
[http://dx.doi.org/10.1007/s00404-010-1587-x] [PMID: 20632182]
[10]
Hsieh TT, Liou JD, Hsu JJ, Lo LM, Chen SF, Hung TH. Advanced maternal age and adverse perinatal outcomes in an Asian population. Eur J Obstet Gynecol Reprod Biol 2010; 148(1): 21-6.
[http://dx.doi.org/10.1016/j.ejogrb.2009.08.022] [PMID: 19773110]
[11]
Kenny LC, Lavender T, McNamee R, O’Neill SM, Mills T, Khashan AS. Advanced maternal age and adverse pregnancy outcome: Evidence from a large contemporary cohort. PLoS One 2013; 8(2): e56583.
[http://dx.doi.org/10.1371/journal.pone.0056583] [PMID: 23437176]
[12]
Almasi-Hashiani A, Sepidarkish M, Safiri S, Khedmati Morasae E, Shadi Y, Omani-Samani R. Understanding determinants of unequal distribution of stillbirth in Tehran, Iran: A concentration index decomposition approach. BMJ Open 2017; 7(5): e013644.
[http://dx.doi.org/10.1136/bmjopen-2016-013644] [PMID: 28515186]
[13]
Sepidarkish M, Almasi-Hashiani A, Maroufizadeh S, Vesali S, Pirjani R, Samani RO. Association between previous spontaneous abortion and pre-eclampsia during a subsequent pregnancy. Int J Gynaecol Obstet 2017; 136(1): 83-6.
[http://dx.doi.org/10.1002/ijgo.12008] [PMID: 28099708]
[14]
Omani-Samani R, Sepidarkish M, Safiri S, et al. Impact of gestational weight gain on cesarean delivery risk, perinatal birth weight and gestational age in women with normal pre-pregnancy BMI. J Obstet Gynaecol India 2018; 68(4): 258-63.
[http://dx.doi.org/10.1007/s13224-017-1023-2] [PMID: 30065539]
[15]
Omani-Samani R, Ranjbaran M, Amini P, Esmailzadeh A, Sepidarkish M, Almasi-Hashiani A. Adverse maternal and neonatal outcomes in women with preeclampsia in Iran. J Matern Fetal Neonatal Med 2019; 32: 212-6.
[http://dx.doi.org/10.1080/14767058.2017.1376643]
[16]
Omani-Samani R, Amini Rarani M, Sepidarkish M, Khedmati Morasae E, Maroufizadeh S, Almasi-Hashiani A. Socioeconomic inequality of unintended pregnancy in the Iranian population: a decomposition approach. BMC Public Health 2018; 18(1): 607.
[http://dx.doi.org/10.1186/s12889-018-5515-5] [PMID: 29739402]
[17]
World Health Organization. Preterm birth, Fact sheet, 2018. Available at: https://www.who.int/news-room/fact-sheets/detail/preterm-birth
[18]
Hughes MM, Black RE, Katz J. 2500-g low birth weight cutoff: history and implications for future research and policy. Matern Child Health J 2017; 21(2): 283-9.
[http://dx.doi.org/10.1007/s10995-016-2131-9] [PMID: 27449779]
[19]
Omani-Samani R, Mansournia MA, Almasi-Hashiani A, et al. Decomposition of socioeconomic inequalities in preterm deliveries in Tehran, Iran. Int J Gynaecol Obstet 2018; 140(1): 87-92.
[http://dx.doi.org/10.1002/ijgo.12347] [PMID: 29023698]
[20]
Ikamari L, Izugbara C, Ochako R. Prevalence and determinants of unintended pregnancy among women in Nairobi, Kenya. BMC Pregnancy Childbirth 2013; 13: 69.
[http://dx.doi.org/10.1186/1471-2393-13-69] [PMID: 23510090]
[21]
Zaheri F, Ranaie F. Hashemi nasab L, Karimeh R, Shahoi R. Unwanted Pregnancy and Associated Factors among Pregnant Women who referred to Sanandaj Health Centers in 2011. Iran J Obstet Gynecol Infertil 2015; 17: 10-5.
[22]
Cheraghi P, Poorolajal J, Moeini B, Cheraghi Z. Predictors of unintended pregnancy among married women in Hamadan, Western Iran: A case-control study. Iran J Public Health 2013; 42(8): 854-9.
[PMID: 26056639]
[23]
Lamina MA. Prevalence and determinants of unintended pregnancy among women in south-western Nigeria. Ghana Med J 2015; 49(3): 187-94.
[http://dx.doi.org/10.4314/gmj.v49i3.10] [PMID: 26693195]
[24]
Lamminpää R, Vehviläinen-Julkunen K, Gissler M, Heinonen S. Preeclampsia complicated by advanced maternal age: A registry-based study on primiparous women in Finland 1997-2008. BMC Pregnancy Childbirth 2012; 12: 47.
[http://dx.doi.org/10.1186/1471-2393-12-47] [PMID: 22687260]
[25]
Azami-Aghdash S, Ghojazadeh M, Dehdilani N, Mohammadi M, Asl Amin Abad R. Prevalence and causes of cesarean section in iran: Systematic review and meta-analysis. Iran J Public Health 2014; 43(5): 545-55.
[PMID: 26060756]
[26]
Bayrampour H, Heaman M. Advanced maternal age and the risk of cesarean birth: A systematic review. Birth 2010; 37(3): 219-26.
[http://dx.doi.org/10.1111/j.1523-536X.2010.00409.x] [PMID: 20887538]
[27]
Barbuscia A, Martikainen P, Myrskylä M, et al. Maternal age and risk of low birth weight and premature birth in children conceived through medically assisted reproduction. Evidence from Finnish population registers. Hum Reprod 2020; 35(1): 212-20.
[http://dx.doi.org/10.1093/humrep/dez275] [PMID: 31967314]
[28]
Fuchs F, Monet B, Ducruet T, Chaillet N, Audibert F. Effect of maternal age on the risk of preterm birth: A large cohort study. PloS One 2018; 13: e0191002.
[http://dx.doi.org/10.1097/01.ogx.0000541308.53092.4a]

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