Schure V, Voigt M, Schild R L, Hesse V, Carstensen M, Schneider K T M, Straube S
Department of Obstetrics and Gynaecology, Diakonische Dienste Hannover, Hannover.
German Center for Growth, Development, and Health Encouragement during Childhood and Youth, Berlin.
Geburtshilfe Frauenheilkd. 2012 Jan;72(1):49-55. doi: 10.1055/s-0031-1280407.
"Late motherhood" is associated with greater perinatal risks but the term lacks precise definition. We present an approach to determine what "late motherhood" associated with "high risk" is, based on parity and preterm birth rate. Using data from the German Perinatal Survey of 1998-2000 we analysed preterm birth rates in women with zero, one, or two previous live births. We compared groups of "late" mothers (with high preterm birth rates) with "control" groups of younger women (with relatively low preterm birth rates). Data of 208 342 women were analysed. For women with zero (one; two) previous live births, the "control" group included women aged 22-26 (27-31; 29-33) years. Women in the "late motherhood" group were aged > 33 (> 35; > 38) years. The "late motherhood" groups defined in this way were also at higher risk of adverse perinatal events other than preterm birth. For women with zero (one; two) previous live births, normal cephalic presentation occurred in 89 % (92.7 %; 93.3 %) in the "control" group, but only in 84.5 % (90 %; 90.4 %) in the "late motherhood" group. The mode of delivery was spontaneous or at most requiring manual help in 71.3 % (83.4 %; 85.8 %) in the "control" group, but only in 51.4 % (72.2 %; 76.4 %) in the "late motherhood" group. Five-minute APGAR scores were likewise worse for neonates of "late" mothers and the proportion with a birth weight ≤ 2499 g was greater. "Late motherhood" that is associated with greater perinatal risks can be defined based on parity and preterm birth rate.
“晚育”与更高的围产期风险相关，但该术语缺乏精确的定义。我们提出了一种基于产次和早产率来确定与“高风险”相关的“晚育”的方法。利用1998 - 2000年德国围产期调查的数据，我们分析了既往有0次、1次或2次活产的女性的早产率。我们将“晚育”母亲组（早产率高）与年轻女性“对照组”（早产率相对较低）进行了比较。分析了208342名女性的数据。对于既往有0次（1次；2次）活产的女性，“对照组”包括年龄在22 - 26岁（27 - 31岁；29 - 33岁）的女性。“晚育”组的女性年龄大于33岁（大于35岁；大于38岁）。以这种方式定义的“晚育”组在早产以外的围产期不良事件方面也有更高的风险。对于既往有0次（1次；2次）活产的女性，“对照组”中89%（92.7%；93.3%）为正常头位分娩，而“晚育”组中仅为84.5%（90%；90.4%）。“对照组”中71.3%（83.4%；85.8%）的分娩方式为自然分娩或最多只需人工辅助，而“晚育”组中仅为51.4%（72.2%；76.4%）。“晚育”母亲的新生儿5分钟阿氏评分同样较差，出生体重≤2499g的比例更高。与更高围产期风险相关的“晚育”可以基于产次和早产率来定义。
