Dakov T, Dimitrova V
Akush Ginekol (Sofiia). 2014;53(1):13-20.
During the past decades there is a tendency among women in developed countries for postponing their reproductive plans for later age. This results from the substantial change of women's role in society and the development and availability of assisted reproduction technologies. The latter made possible women to become pregnant after the end of their reproductive years. In the present review, data from the literature, published in the recent 15 years and related to pregnancy course and outcome in women above the age of 35, are analyzed. Decreased fertility, higher incidence of early pregnancy complications including spontaneous abortions and ectopic pregnancy, and of congenital anomalies (chromosomal, structural, genetic syndromes) are discussed. Advanced maternal age is characterized with more frequent late pregnancy complication such as hypertension and diabetes. Problems of placentation, perinatal and maternal mortality are more frequent in these patients.. Data at present suggest higher risk for maternal and fetal pregnancy complications as maternal age advances. On the other hand, some positive aspects of postponing pregnancy have to be considered--financial, emotional, and the overall low absolute number of complications. With adequate antenatal care it is possible for women of advanced maternal age to have successful pregnancies with overall favorable outcome comparable to that in young women.
在过去几十年里，发达国家的女性有推迟生育计划至更高年龄的趋势。这是由于女性社会角色的重大转变以及辅助生殖技术的发展与普及。后者使女性在生殖年龄结束后仍有可能怀孕。在本综述中，分析了最近15年发表的、与35岁以上女性妊娠过程及结局相关的文献数据。讨论了生育力下降、早期妊娠并发症（包括自然流产和宫外孕）以及先天性异常（染色体、结构、遗传综合征）的发生率增加。高龄孕产妇的特点是晚期妊娠并发症（如高血压和糖尿病）更为常见。这些患者胎盘形成、围产期和孕产妇死亡问题更为频繁。目前的数据表明，随着孕产妇年龄的增加，母婴妊娠并发症的风险更高。另一方面，必须考虑推迟妊娠的一些积极方面——经济、情感以及总体较低的绝对并发症数量。通过适当的产前护理，高龄孕产妇有可能成功妊娠，总体结局良好，与年轻女性相当。
