Bayrampour Hamideh, Heaman Maureen
Applied Health Sciences PhD Program, University of Manitoba, Winnipeg MB.
Faculty of Nursing, University of Manitoba, Winnipeg MB.
J Obstet Gynaecol Can. 2011 Aug;33(8):820-829. doi: 10.1016/S1701-2163(16)34985-4.
The rate of pregnancy at advanced maternal age (AMA) has increased during recent decades. The purpose of this study is to compare demographic and obstetric characteristics of Canadian primiparous women of AMA with those aged 20 to 29 years.
We conducted a secondary analysis of data collected through the national Maternity Experiences Survey (MES) of the Canadian Perinatal Surveillance System. The sample included 301 primiparous women aged 35 years or over and 1,564 primiparous women aged 20 to 29 years. Estimates of prevalence for each group and their odds ratios were calculated using sample weights of the survey, and variances were calculated using bootstrapping methods adjusting for sampling design and weights.
Women of AMA were significantly more likely to be better educated, to have higher income, to be employed, and to continue to work until the end of pregnancy than younger women. They also reported having significantly more information on pregnancy, labour, and birth, and they were more likely to attend prenatal classes. They were more likely to have had a miscarriage or infertility treatment, to request or be offered a Caesarean section, and to have a higher rate of Caesarean section. There were no significant differences in rates of preterm birth, low birth weight, and small-for-gestational age infants.
Pregnant women of AMA differ from younger women in demographic characteristics, knowledge level, and some health behaviours and pregnancy outcomes. The growing number of pregnancies at AMA indicates the need for developing appropriate care plans to address the specific needs of this group.
近几十年来，高龄孕产妇（AMA）的妊娠率有所上升。本研究的目的是比较加拿大AMA初产妇与20至29岁初产妇的人口统计学和产科特征。
我们对通过加拿大围产期监测系统的全国孕产妇经历调查（MES）收集的数据进行了二次分析。样本包括301名35岁及以上的初产妇和1564名20至29岁的初产妇。使用调查的样本权重计算每组的患病率估计值及其比值比，并使用调整抽样设计和权重的自助法计算方差。
与年轻女性相比，AMA女性受教育程度更高、收入更高、就业且直到怀孕结束仍继续工作的可能性显著更高。她们还报告称，在妊娠、分娩和生产方面掌握的信息显著更多，且更有可能参加产前课程。她们更有可能有过流产或接受过不孕治疗，要求或接受剖宫产，且剖宫产率更高。早产、低出生体重和小于胎龄儿的发生率没有显著差异。
AMA孕妇在人口统计学特征、知识水平、一些健康行为和妊娠结局方面与年轻女性不同。AMA妊娠数量的增加表明需要制定适当的护理计划以满足该群体的特殊需求。
