Fayed Amel A, Wahabi Hayfaa, Mamdouh Heba, Kotb Reham, Esmaeil Samia
Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
College of Medicine, Clinical department, Princess Nourah Bint Abdulrahman University, Riyadh, Riyadh, Saudi Arabia.
BMJ Open. 2017 Sep 11;7(9):e016501. doi: 10.1136/bmjopen-2017-016501.
To investigate the impact of maternal age on pregnancy outcomes with special emphasis on adolescents and older mothers and to investigate the differences in demographic profile between adolescents and older mothers.
This study is a secondary analysis of pregnancy outcomes of women in Riyadh Mother and Baby cohort study according to maternal age. The study population was grouped according to maternal age into five subgroups; <20, 20-29, 30-34, 35-39 and 40+years. The age group 20-29 years was considered as a reference group. Investigation of maternal age impact on maternal and neonatal outcomes was conducted with adjustment of confounders using regression models.
All mothers were married when conceived with the index pregnancy. Young mothers were less likely to be illiterate, more likely to achieve higher education and be employed compared with mothers ≥ 40 years. Compared with the reference group, adolescents were more likely to have vaginal delivery (and least likely to deliver by caesarean section (CS); OR=0.6, 95% CI 0.4 to 0.9, while women ≥40 years, were more likely to deliver by CS; OR 2.9, 95% CI 2.3 to 3.7. Maternal age was a risk factor for gestational diabetes in women ≥40 years; OR 1.7, 95% CI 1.3 to 2.1. Adolescents had increased risk of preterm delivery; OR 1.5, 95% CI 1.1 to 2.1 and women ≥40 years had similar risk; OR, 1.3, 95% CI 1.1 to 1.6.
Adverse pregnancy outcomes show a continuum with the advancement of maternal age. Adolescents mother are more likely to have vaginal delivery; however, they are at increased risk of preterm delivery. Advanced maternal age is associated with increased risk of preterm delivery, gestational diabetes and CS.
研究母亲年龄对妊娠结局的影响，特别关注青少年母亲和高龄母亲，并调查青少年母亲和高龄母亲在人口统计学特征上的差异。
本研究是对利雅得母婴队列研究中女性妊娠结局按母亲年龄进行的二次分析。研究人群根据母亲年龄分为五个亚组：<20岁、20 - 29岁、30 - 34岁、35 - 39岁和40岁及以上。将20 - 29岁年龄组作为参照组。采用回归模型调整混杂因素，研究母亲年龄对母亲和新生儿结局的影响。
所有母亲在怀上本次指数妊娠时均已结婚。与40岁及以上母亲相比，年轻母亲文盲的可能性较小，获得高等教育和就业的可能性更大。与参照组相比，青少年母亲更有可能顺产（剖宫产的可能性最小；比值比=0.6，95%置信区间0.4至0.9），而40岁及以上女性剖宫产的可能性更大；比值比2.9，95%置信区间2.3至3.7。母亲年龄是40岁及以上女性患妊娠期糖尿病的危险因素；比值比1.7，95%置信区间1.3至2.1。青少年母亲早产风险增加；比值比1.5，95%置信区间1.1至2.1，40岁及以上女性有类似风险；比值比1.3，95%置信区间1.1至1.6。
不良妊娠结局随着母亲年龄的增长呈连续变化。青少年母亲更有可能顺产；然而，她们早产的风险增加。高龄母亲与早产、妊娠期糖尿病和剖宫产风险增加有关。
