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Association between advanced maternal age and maternal and neonatal morbidity: A cross-sectional study on a Spanish population


Autoři: Ana Casteleiro aff001;  María Paz-Zulueta aff002;  Paula Parás-Bravo aff002;  Laura Ruiz-Azcona aff002;  Miguel Santibañez aff002
Působiště autorů: Hospital Universitario de Basurto, Bilbao, Spain aff001;  Department of Nursing, University of Cantabria, Cantabria, Spain aff002;  IDIVAL, GRIDES, Cantabria, Spain aff003;  IDIVAL, Grupo de Investigación en Enfermería, Cantabria, Spain aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0225074

Souhrn

Background and objective

Over recent decades, a progressive increase in the maternal age at childbirth has been observed in developed countries, posing a health risk for both women and infants. The aim of this study was to analyze the association between advanced maternal age (AMA) and maternal and neonatal morbidity.

Material and methods

A cross-sectional study of 3,315 births was conducted in the north of Spain in 2014. We compared childbirth between women aged 35 years or older, with a reference group of women aged between 24 and 27 years. AMA was categorized based on ordinal ranking into 35–38 years, 39–42 years, and >42 years to estimate a dose-response pattern (the older the age, the greater the risk). As an association measure, crude and adjusted Odds Ratios (OR) were estimated by non-conditional logistic regression and 95% Confidence Intervals (95%CI) were calculated.

Results

Repeated abortions were more common among women of AMA in comparison to pregnant women aged 24–27 years (reference group): adjusted OR = 2.68; 95%CI (1.52–4.73). A higher prevalence of gestational diabetes was also observed among women of AMA, reaching statistical significance when restricted to first time mothers: adjusted OR = 8.55; 95%CI (1.12–65.43). In addition, the possibility of an instrumental delivery was multiplied by 1.6 and the possibility of a cesarean by 1.5 among women of AMA, with these results reaching statistical significance, and observing a dose-response pattern. Lastly, there were associations between preeclampsia, preterm birth (<37 weeks) and low birthweight, however without reaching statistical significance.

Conclusion

Our results support the association between AMA and suffering repeated abortions. Likewise, being of AMA was associated with a greater risk of suffering from gestational diabetes, especially among primiparous women, as well as being associated with both instrumental deliveries and cesareans among both primiparous and multiparous women.

Klíčová slova:

Birth – Cesarean section – Labor and delivery – Morbidity – Neonates – Preeclampsia


Zdroje

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