Amy M Valent1, Tondra Newman1, Aimin Chen2, Amy Thompson1, Emily DeFranco1,3. 1. a Department of Obstetrics and Gynecology , and. 2. b Department of Environmental Health , University of Cincinnati , Cincinnati , OH , USA , and. 3. c Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.
Abstract
OBJECTIVE: Compare significant neonatal morbidity frequency differences in advanced maternal age (AMA) versus non-AMA pregnancies, assessing which gestational week is associated with the lowest morbidity risk. METHODS: Population-based retrospective cohort study. Adverse neonatal outcome frequency differences were stratified by each week of gestation. Multivariate logistic regression estimated the relative risk (RR) of composite neonatal morbidity for women aged 35-39, 40-44, 45-49 and 50-55 versus 18-34 years, adjusted sequentially for relevant risk factors. RESULTS: Neonatal morbidity decreased with each advancing week of term gestation, lowest at 39 weeks for all the groups. Adverse neonatal outcome risk for births to AMA women increased at 40 weeks: 35-39 years adjRR 1.12 [1.01-1.24] and ≥40 years 1.24 [1.01-1.52]. Each older maternal age category had increased risk for overall neonatal morbidity: 35-39 years adjRR 1.11 [95% CI 1.08-1.15], 40-44 years 1.21 [95% CI 1.14-1.29] and 45-49 years 1.34 [95% CI 1.05-1.69]. CONCLUSIONS: Lowest neonatal morbidity risk is at 39-week gestation with a significantly increased risk observed thereafter, especially in women ≥40 years.
OBJECTIVE: Compare significant neonatal morbidity frequency differences in advanced maternal age (AMA) versus non-AMA pregnancies, assessing which gestational week is associated with the lowest morbidity risk. METHODS: Population-based retrospective cohort study. Adverse neonatal outcome frequency differences were stratified by each week of gestation. Multivariate logistic regression estimated the relative risk (RR) of composite neonatal morbidity for women aged 35-39, 40-44, 45-49 and 50-55 versus 18-34 years, adjusted sequentially for relevant risk factors. RESULTS: Neonatal morbidity decreased with each advancing week of term gestation, lowest at 39 weeks for all the groups. Adverse neonatal outcome risk for births to AMA women increased at 40 weeks: 35-39 years adjRR 1.12 [1.01-1.24] and ≥40 years 1.24 [1.01-1.52]. Each older maternal age category had increased risk for overall neonatal morbidity: 35-39 years adjRR 1.11 [95% CI 1.08-1.15], 40-44 years 1.21 [95% CI 1.14-1.29] and 45-49 years 1.34 [95% CI 1.05-1.69]. CONCLUSIONS: Lowest neonatal morbidity risk is at 39-week gestation with a significantly increased risk observed thereafter, especially in women ≥40 years.
Authors: Mert Ozan Bahtiyar; Edmund F Funai; Victor Rosenberg; Errol Norwitz; Heather Lipkind; Catalin Buhimschi; Joshua A Copel Journal: Am J Perinatol Date: 2008-04-24 Impact factor: 1.862
Authors: Jaideep Kanungo; Andrew James; Douglas McMillan; Abhay Lodha; Daniel Faucher; Shoo K Lee; Prakesh S Shah Journal: Obstet Gynecol Date: 2011-10 Impact factor: 7.661
Authors: Alessandro Favilli; Silvia Pericoli; Marta Maddalena Acanfora; Vittorio Bini; Gian Carlo Di Renzo; Sandro Gerli Journal: J Matern Fetal Neonatal Med Date: 2012-04-03