Pregnancy outcomes for nulliparous women of advanced maternal age in South Australia, 1998-2008

The Australian & New Zealand Journal of Obstetrics & Gynaecology
Isobel LudfordRosalie Grivell

Abstract

Child bearing in the later reproductive years has become increasingly common in Australia with potential implications for clinical practice. To examine pregnancy outcomes for nulliparous women of advanced maternal age with singleton pregnancies. A retrospective population-based cohort study was conducted to compare the pregnancy outcomes for women aged 35-39 years and ≥40 years with women aged 25-29 years, analysing 34 695 records from the South Australian Perinatal Database between 1998 and 2008. Pre-existing hypertension [relative risks (RR) 1.98 and 2.94 for women aged 35-39 years and ≥40 years, respectively], placenta praevia (RR 2.88 and 3.68), suspected intrauterine growth restriction (RR 1.33 and 1.77) and gestational diabetes (RR 1.97 and 2.53) increased with age. Women of advanced maternal age were more likely to have not laboured prior to birth (RR 2.19 and 3.28), be induced (RR 1.12 and 1.27) and have a breech presentation (RR 1.57 and 1.60). The likelihood of fetal distress increased with advancing maternal age (RR 1.15 and 1.24). Regression analyses revealed women of advanced maternal age were significantly more likely to have small for gestational age infants [adjusted odds ratios (AOR) 1.26 and 1.50], preterm bir...Continue Reading

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