Impact of advanced maternal age on the outcome of pregnancy.

We assessed the impact of advanced maternal age on the outcome of pregnancy by studying all 1,328 women who were primarily cared for and delivered at our institution between 14 September 1984 and 12 February 1985. Important peripartum maternal complications were no more frequent in women aged 35 years or more than in women 20 to 34 years old, although operative delivery was significantly more common. Similarly, adverse outcomes of infants were no more frequent. Perinatal mortality tended to be lower. In addition, we noted a trend for fewer infants with congenital anomalies to be born among older women. This trend was related, in part, to the choice to terminate the pregnancy by women with fetuses that had documented chromosomal anomalies. We conclude that advanced maternal age was not associated with an excess of adverse pregnancy outcome and suggest that, with early registration and careful surveillance during pregnancy, women aged 35 years or more can experience excellent pregnancy outcomes.