Valent Amy M, Newman Tondra, Chen Aimin, Thompson Amy, DeFranco Emily
a Department of Obstetrics and Gynecology , and.
b Department of Environmental Health , University of Cincinnati , Cincinnati , OH , USA , and.
J Matern Fetal Neonatal Med. 2016;29(9):1485-90. doi: 10.3109/14767058.2015.1051955. Epub 2015 Jun 5.
Compare significant neonatal morbidity frequency differences in advanced maternal age (AMA) versus non-AMA pregnancies, assessing which gestational week is associated with the lowest morbidity risk.
Population-based retrospective cohort study. Adverse neonatal outcome frequency differences were stratified by each week of gestation. Multivariate logistic regression estimated the relative risk (RR) of composite neonatal morbidity for women aged 35-39, 40-44, 45-49 and 50-55 versus 18-34 years, adjusted sequentially for relevant risk factors.
Neonatal morbidity decreased with each advancing week of term gestation, lowest at 39 weeks for all the groups. Adverse neonatal outcome risk for births to AMA women increased at 40 weeks: 35-39 years adjRR 1.12 [1.01-1.24] and ≥40 years 1.24 [1.01-1.52]. Each older maternal age category had increased risk for overall neonatal morbidity: 35-39 years adjRR 1.11 [95% CI 1.08-1.15], 40-44 years 1.21 [95% CI 1.14-1.29] and 45-49 years 1.34 [95% CI 1.05-1.69].
Lowest neonatal morbidity risk is at 39-week gestation with a significantly increased risk observed thereafter, especially in women ≥40 years.
比较高龄孕产妇（AMA）与非高龄孕产妇妊娠中显著的新生儿发病率差异，评估哪个孕周的发病风险最低。
基于人群的回顾性队列研究。不良新生儿结局的频率差异按孕周分层。多因素逻辑回归估计了35 - 39岁、40 - 44岁、45 - 49岁和50 - 55岁女性与18 - 34岁女性相比复合新生儿发病率的相对风险（RR），并依次对相关风险因素进行校正。
足月妊娠孕周每增加一周，新生儿发病率降低，所有组在39周时最低。AMA女性分娩时不良新生儿结局风险在40周时增加：35 - 39岁校正RR为1.12[1.01 - 1.24]，≥40岁为1.24[1.01 - 1.52]。每个较高年龄组的孕产妇总体新生儿发病风险均增加：35 - 39岁校正RR为1.11[95%CI 1.08 - 1.15]，40 - 44岁为1.21[95%CI 1.14 - 1.29]，45 - 49岁为1.34[95%CI 1.05 - 1.69]。
新生儿发病风险最低的孕周是39周，此后风险显著增加，尤其是40岁及以上的女性。
