Hoffman M Camille, Jeffers Sarah, Carter Jena, Duthely Lunthita, Cotter Amanda, González-Quintero Víctor Hugo
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, FL 33101, USA.
Am J Obstet Gynecol. 2007 May;196(5):e11-3. doi: 10.1016/j.ajog.2006.10.862.
The objective of the study was to determine the frequency of fetal death in women 40 years of age or older (AMA).
Retrospective study of all singleton pregnancies delivered at our institution between the years 1989 and 2004 was performed. The primary outcome measure was the risk of fetal death at various gestational ages. We also investigated the frequency of maternal comorbidities, preterm delivery (PTD), and low and very low birth weights (LBW, VLBW).
Data were available for 126,402 singleton deliveries. AMA was an independent risk factor for fetal death at 28-31 weeks (adjusted odds ratio [AOR] 2.93, 95% confidence interval [CI] 1.76-4.92), 32-36 (AOR 1.73, 95% CI 1.05-2.83), 37-39 weeks (AOR 1.63, 95% CI 0.97-2.75), and 40-41 weeks (AOR 2.28, 95% CI 1.18-4.4). AMA was associated with increased rates of PTD, LBW, and VLBW.
AMA is associated with an increased rate of fetal death and other adverse obstetrical outcomes. Antepartum fetal surveillance may be warranted in these women.
本研究的目的是确定40岁及以上高龄产妇（AMA）中胎儿死亡的发生率。
对1989年至2004年间在我们机构分娩的所有单胎妊娠进行回顾性研究。主要结局指标是不同孕周时胎儿死亡的风险。我们还调查了孕产妇合并症、早产（PTD）以及低出生体重和极低出生体重（LBW、VLBW）的发生率。
有126,402例单胎分娩的数据可用。高龄产妇是28 - 31周（校正比值比[AOR] 2.93，95%置信区间[CI] 1.76 - 4.92）、32 - 36周（AOR 1.73，95% CI 1.05 - 2.83）、37 - 39周（AOR 1.63，95% CI 0.97 - 2.75）以及40 - 41周（AOR 2.28，95% CI 1.18 - 4.4）时胎儿死亡的独立危险因素。高龄产妇与早产、低出生体重和极低出生体重的发生率增加相关。
高龄产妇与胎儿死亡及其他不良产科结局的发生率增加相关。这些女性可能需要进行产前胎儿监测。
