Haslinger Christian, Stoiber Bernhard, Capanna Federica, Schäffer Marie-Kristin, Zimmermann Roland, Schäffer Leonhard
Division of Obstetrics, University Hospital of Zürich, Switzerland.
Division of Obstetrics, Kantonsspital Baden, Switzerland.
Swiss Med Wkly. 2016 Aug 6;146:w14330. doi: 10.4414/smw.2016.14330. eCollection 2016.
To evaluate pregnancy outcome in pregnant women aged ≥45 years, termed very advanced maternal age (VAMA).
We retrospectively compared the outcome of pregnancies in VAMA patients with controls aged 30 years at time of delivery. Subgroups of singleton and multiple pregnancies were also analysed. Incidences of maternal and fetal adverse outcomes were measured. Statistical significance was set at p <0.05. Odds ratios (ORs) were adjusted where necessary.
One hundred and twenty-seven VAMA pregnancies and 2066 control pregnancies of women aged 30 years were analysed. VAMA pregnancies had a higher rate of maternal complications such as gestational hypertension (3.9% vs 0.6%; OR 6.5), preeclampsia (14.2% vs 3.0%; OR 5.4, adjusted OR 4.4) and gestational diabetes (12.6% vs 3.6%; OR 3.8). Likewise, increased need for blood transfusion (3.2% vs 0.7%; OR 4.8, adjusted OR 4.4) and prolonged hospitalisation >7 days (37.8% vs 15.1%; OR 3.42) was found. Infant complications such as prematurity (44.9% vs 16.2%; OR 4.2) and low birthweight <5th percentile (11.0% vs 5.6%; OR 2.1) were also increased.
Pregnant women of very advanced maternal age (≥45 years) have significantly increased maternal and fetal risks. Women postponing pregnancy or planning a pregnancy in very advanced age should be informed about these risks, in particular before artificial reproductive technologies are applied or "social freezing".
评估年龄≥45岁的孕妇（即高龄孕产妇）的妊娠结局。
我们回顾性比较了高龄孕产妇与分娩时年龄为30岁的对照组孕妇的妊娠结局。还分析了单胎和多胎妊娠的亚组。测量了母婴不良结局的发生率。设定统计学显著性为p<0.05。必要时对优势比（OR）进行调整。
分析了127例高龄孕产妇妊娠和2066例年龄为30岁女性的对照妊娠。高龄孕产妇妊娠的孕产妇并发症发生率较高，如妊娠期高血压（3.9%对0.6%；OR 6.5）、子痫前期（14.2%对3.0%；OR 5.4，调整后OR 4.4）和妊娠期糖尿病（12.6%对3.6%；OR 3.8）。同样，发现输血需求增加（3.2%对0.7%；OR 4.8，调整后OR 4.4）和住院时间延长>7天（37.8%对15.1%；OR 3.42）。婴儿并发症如早产（44.9%对16.2%；OR 4.2）和出生体重低于第5百分位数（11.0%对5.6%；OR 2.1）也有所增加。
高龄孕产妇（≥45岁）的母婴风险显著增加。推迟妊娠或计划高龄妊娠的女性应了解这些风险，尤其是在应用辅助生殖技术或“社会冷冻”之前。
