Department of Fetal Medicine, Institute for Women's Health, University College London Hospitals, London, UK.
Ultrasound Obstet Gynecol. 2013 Dec;42(6):634-43. doi: 10.1002/uog.12494.
To examine the association between maternal age and a wide range of adverse pregnancy outcomes after adjustment for confounding factors in obstetric history and maternal characteristics.
This was a retrospective study in women with singleton pregnancies attending the first routine hospital visit at 11 + 0 to 13 + 6 weeks' gestation. Data on maternal characteristics, and medical and obstetric history were collected and pregnancy outcomes ascertained. Maternal age was studied, both as a continuous and as a categorical variable. Regression analysis was performed to examine the association between maternal age and adverse pregnancy outcome including pre-eclampsia, gestational hypertension, gestational diabetes mellitus (GDM), preterm delivery, small-for-gestational age (SGA) neonate, large-for-gestational age (LGA) neonate, miscarriage, stillbirth and elective and emergency Cesarean section.
The study population included 76 158 singleton pregnancies with a live fetus at 11 + 0 to 13 + 6 weeks. After adjusting for potential maternal and pregnancy confounding variables, advanced maternal age (defined as ≥ 40 years) was associated with increased risk of miscarriage (odds ratio (OR), 2.32 (95% CI, 1.83-2.93); P < 0.001), pre-eclampsia (OR, 1.49 (95% CI, 1.22-1.82); P < 0.001), GDM (OR, 1.88 (95% CI, 1.55-2.29); P < 0.001), SGA (OR, 1.46 (95% CI, 1.27-1.69); P < 0.001) and Cesarean section (OR, 1.95 (95% CI, 1.77-2.14); P < 0.001), but not with stillbirth, gestational hypertension, spontaneous preterm delivery or LGA.
Maternal age should be combined with other maternal characteristics and obstetric history when calculating an individualized adjusted risk for adverse pregnancy complications. Advanced maternal age is a risk factor for miscarriage, pre-eclampsia, SGA, GDM and Cesarean section, but not for stillbirth, gestational hypertension, spontaneous preterm delivery or LGA.
在调整产科史和产妇特征中的混杂因素后，研究产妇年龄与多种不良妊娠结局之间的关系。
这是一项在 11+0 至 13+6 孕周首次常规医院就诊的单胎妊娠妇女中进行的回顾性研究。收集产妇特征、医疗和产科史数据，并确定妊娠结局。研究了产妇年龄，既作为连续变量，也作为分类变量。回归分析用于检查产妇年龄与不良妊娠结局（包括子痫前期、妊娠期高血压、妊娠期糖尿病、早产、小于胎龄儿（SGA）新生儿、大于胎龄儿（LGA）新生儿、流产、死产和选择性及紧急剖宫产）之间的关系。
研究人群包括 76158 例在 11+0 至 13+6 孕周有活胎的单胎妊娠。在调整潜在的产妇和妊娠混杂变量后，高龄产妇（定义为≥40 岁）与流产风险增加相关（优势比（OR），2.32（95%置信区间，1.83-2.93）；P<0.001）、子痫前期（OR，1.49（95%置信区间，1.22-1.82）；P<0.001）、妊娠期糖尿病（OR，1.88（95%置信区间，1.55-2.29）；P<0.001）、SGA（OR，1.46（95%置信区间，1.27-1.69）；P<0.001）和剖宫产（OR，1.95（95%置信区间，1.77-2.14）；P<0.001）相关，但与死产、妊娠期高血压、自发性早产或 LGA 无关。
在计算不良妊娠并发症的个体化调整风险时，应将产妇年龄与其他产妇特征和产科史结合起来。高龄产妇是流产、子痫前期、SGA、妊娠期糖尿病和剖宫产的危险因素，但不是死产、妊娠期高血压、自发性早产或 LGA 的危险因素。
