Malignant potential of gestational trophoblastic disease at the extreme ages of reproductive life.

The effect of maternal age on the incidence and significance of hydatidiform mole in 2202 patients studied at the Southeastern Regional Trophoblastic Disease Center during 1978 to 1982 is analyzed. Results are compared with a contemporary control group that comprised all types of pregnancy events. A significant increase (P less than .001) in the incidence of hydatidiform mole was seen in women 15 years of age or less and 40 years of age or more. A significant decrease (P less than .001) in the incidence of hydatidiform mole was seen in women in the 20 to 29-year age group. The greatest relative risk of hydatidiform mole occurred in women 50 years of age and older (relative risk = 519). The malignant sequelae rate from hydatidiform mole was 21.7% for the entire group. The relative risk of malignant gestational trophoblastic disease was lowest among patients 15 years of age and less (13.9%) and highest in patients 50 years of age and more (37.5%), but the differences were not significant (P greater than .05). The findings of the present study are compared with the previous literature and management recommendations are made.