New indications for antepartum testing: making the case for antepartum surveillance or timed delivery for women of advanced maternal age.

Maternal age is an independent risk factor for stillbirth; a moderate number of these occur in normally formed babies near term. For a woman 40 years of age or older giving birth, her risk of having a chromosomal anomaly is 1/66. What is not appreciated is that even without medical risk factors, her risk of having a stillbirth after 37 weeks of gestation is 1/116. This article reviews the risks and benefits of the strategy of antepartum testing and timed delivery and discusses the limitations of the available data in this field.