Department of Nursing Science, University of Eastern Finland, PO, Box, 1627, Kuopio, 70211, Finland.
BMC Pregnancy Childbirth. 2012 Jun 11;12:47. doi: 10.1186/1471-2393-12-47.
Preeclampsia is a frequent syndrome and its cause has been linked to multiple factors, making prevention of the syndrome a continuous challenge. One of the suggested risk factors for preeclampsia is advanced maternal age. In the Western countries, maternal age at first delivery has been steadily increasing, yet few studies have examined women of advanced maternal age with preeclampsia. The purpose of this registry-based study was to compare the obstetric outcomes in primiparous and preeclamptic women younger and older than 35 years.
The registry-based study used data from three Finnish health registries: Finnish Medical Birth Register, Finnish Hospital Discharge Register and Register of Congenital Malformations. The sample contained women under 35 years of age (N = 15,437) compared with those 35 and over (N = 2,387) who were diagnosed with preeclampsia and had their first singleton birth in Finland between 1997 and 2008. In multivariate modeling, the main outcome measures were Preterm delivery (before 34 and 37 weeks), low Apgar score (5 min.), small-for-gestational-age, fetal death, asphyxia, Cesarean delivery, induction, blood transfusion and admission to a Neonatal Intensive Care Unit.
Women of advanced maternal age (AMA) exhibited more preeclampsia (9.4%) than younger women (6.4%). They had more prior terminations (<0.001), were more likely to have a body mass index (BMI) >25 (<0.001), had more in vitro fertilization (IVF) (<0.001) and other fertility treatments (<0.001) and a higher incidence of maternal diabetes (<0.001) and chronic hypertension (<0.001). Multivariate logistic regression indicated that women of AMA had higher rates of: preterm delivery before 37 weeks 19.2% (OR 1.39 CI 1.24 to 1.56) and before 34 weeks 8.7% (OR 1.68 CI 1.43 to 2.00) low Apgar scores at 5 min. 7.1% (OR 1.37 CI 1.00 to 1.88), Small-for-Gestational Age (SGA) 26.5% (OR 1.42 CI 1.28 to 1.57), Asphyxia 12.1% (OR 1.54 CI 1.34 to 1.77), Caesarean delivery 50% (OR 2.02 CI 1.84 to 2.20) and admission to a Neonatal Intensive Care Unit (NICU) 31.6% (OR 1.45 CI 1.32 to 1.60).
Preeclampsia is more common in women with advanced maternal age. Advanced maternal age is an independent risk factor for adverse outcomes in first-time mothers with preeclampsia.
子痫前期是一种常见的综合征，其病因与多种因素有关，因此预防该综合征一直是一个挑战。子痫前期的一个建议风险因素是高龄产妇。在西方国家，初产妇的年龄一直在稳步上升，但很少有研究检查过高龄产妇的子痫前期。本基于登记的研究旨在比较年轻和高龄初产妇（年龄小于 35 岁）与子痫前期患者的产科结局。
基于登记的研究使用了来自芬兰三个健康登记处的数据：芬兰医疗出生登记处、芬兰住院病人出院登记处和先天性畸形登记处。样本包括年龄小于 35 岁（N=15437）的女性，以及年龄在 35 岁及以上（N=2387）且在芬兰于 1997 年至 2008 年间首次单胎分娩时被诊断为子痫前期的女性。在多变量建模中，主要结局指标是早产（34 周前和 37 周前）、低阿普加评分（5 分钟）、小于胎龄儿、胎儿死亡、窒息、剖宫产、引产、输血和入住新生儿重症监护病房。
高龄产妇（AMA）子痫前期的发病率（9.4%）高于年轻女性（6.4%）。她们的终止妊娠（<0.001）次数更多，更有可能 BMI 大于 25（<0.001），更有可能进行体外受精（IVF）（<0.001）和其他生育治疗（<0.001），以及更高的母体糖尿病（<0.001）和慢性高血压（<0.001）发生率。多变量逻辑回归表明，AMA 组的早产发生率更高：37 周前早产 19.2%（OR 1.39，95%CI 1.24 至 1.56），34 周前早产 8.7%（OR 1.68，95%CI 1.43 至 2.00）；5 分钟时低 Apgar 评分 7.1%（OR 1.37，95%CI 1.00 至 1.88）；小于胎龄儿（SGA）26.5%（OR 1.42，95%CI 1.28 至 1.57）；窒息 12.1%（OR 1.54，95%CI 1.34 至 1.77）；剖宫产 50%（OR 2.02，95%CI 1.84 至 2.20）；新生儿重症监护病房（NICU）入住率 31.6%（OR 1.45，95%CI 1.32 至 1.60）。
子痫前期在高龄产妇中更为常见。高龄产妇是初产妇子痫前期不良结局的独立危险因素。
