Jordana Leader1, Amrit Bajwa2, Andrea Lanes3, Xiaolin Hua4, Ruth Rennicks White2, Natalie Rybak2, Mark Walker5. 1. OMNI Research Group, Clinical Epidemiology Program, Ottawa Health Research Group, Ottawa, ON. Electronic address: leaderje@bu.edu. 2. OMNI Research Group, Clinical Epidemiology Program, Ottawa Health Research Group, Ottawa, ON. 3. OMNI Research Group, Clinical Epidemiology Program, Ottawa Health Research Group, Ottawa, ON; University of Ottawa School of Epidemiology, Public Health and Preventive Medicine, Ottawa, ON; BORN Ontario, Ottawa, ON. 4. OMNI Research Group, Clinical Epidemiology Program, Ottawa Health Research Group, Ottawa, ON; Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; University of Ottawa Department of Obstetrics and Gynecology, Ottawa, ON. 5. OMNI Research Group, Clinical Epidemiology Program, Ottawa Health Research Group, Ottawa, ON; BORN Ontario, Ottawa, ON; University of Ottawa Department of Obstetrics and Gynecology, Ottawa, ON.
Abstract
OBJECTIVE: To summarize information on the maternal and perinatal outcomes among pregnant women with a maternal age greater or equal to 45 years old compared with women with a maternal age of less than 45. METHODS: A comprehensive systematic search of online databases from January 1946 through June 2015 was completed. The maternal outcomes were: fetal loss, preterm birth, full-term birth, complications of pregnancy, the type of delivery, and periconception hemorrhage. The fetal outcomes were: intrauterine growth restriction/LGA, fetal anomalies, APGAR score, and neonatal death. RESULTS: Twenty articles were included in the systematic review and 15 included in the meta-analysis. There was a 2.60 greater likelihood of fetal loss (I2 = 99%). Newborns of women of a very advanced maternal age were 2.49 more likely to have a concerning 5-minute APGAR score. Very advanced maternal age women had a 3.32 greater likelihood of pregnancy complications (I2 = 91%). There was a 1.96 greater likelihood of preterm birth at very advanced maternal age (I2 = 91%) and a 4 times greater likelihood of having to deliver through Caesarean section (I2 = 97%). CONCLUSION: This systematic review showed an increased risk of adverse maternal and perinatal outcomes. The large amount of heterogeneity among most outcomes that were investigated suggest results must be interpreted with caution.
OBJECTIVE: To summarize information on the maternal and perinatal outcomes among pregnant women with a maternal age greater or equal to 45 years old compared with women with a maternal age of less than 45. METHODS: A comprehensive systematic search of online databases from January 1946 through June 2015 was completed. The maternal outcomes were: fetal loss, preterm birth, full-term birth, complications of pregnancy, the type of delivery, and periconception hemorrhage. The fetal outcomes were: intrauterine growth restriction/LGA, fetal anomalies, APGAR score, and neonatal death. RESULTS: Twenty articles were included in the systematic review and 15 included in the meta-analysis. There was a 2.60 greater likelihood of fetal loss (I2 = 99%). Newborns of women of a very advanced maternal age were 2.49 more likely to have a concerning 5-minute APGAR score. Very advanced maternal age women had a 3.32 greater likelihood of pregnancy complications (I2 = 91%). There was a 1.96 greater likelihood of preterm birth at very advanced maternal age (I2 = 91%) and a 4 times greater likelihood of having to deliver through Caesarean section (I2 = 97%). CONCLUSION: This systematic review showed an increased risk of adverse maternal and perinatal outcomes. The large amount of heterogeneity among most outcomes that were investigated suggest results must be interpreted with caution.
Authors: Tinu M Samuel; Olga Sakwinska; Kimmo Makinen; Graham C Burdge; Keith M Godfrey; Irma Silva-Zolezzi Journal: Nutrients Date: 2019-08-06 Impact factor: 5.717
Authors: Ana Casteleiro; María Paz-Zulueta; Paula Parás-Bravo; Laura Ruiz-Azcona; Miguel Santibañez Journal: PLoS One Date: 2019-11-26 Impact factor: 3.240