Marques Bárbara, Palha Francisca, Moreira Edgar, Valente Sandra, Abrantes Margarida, Saldanha Joana
Serviço de Neonatologia. Departamento de Pediatria. Hospital Universitário de Santa Maria. Centro Académico de Medicina de Lisboa. Lisboa. Portugal.
Acta Med Port. 2017 Sep 29;30(9):615-622. doi: 10.20344/amp.8319.
Advanced maternal age is defined as maternity after 35 years old and is associated with more complications during pregnancy and neonatal period as well as decreased fertility. This study aims to examine the relationship between advanced maternal age and their maternal and fetal consequences, as well as maternal perception of the risk of pregnancy after 35 years old.
Observational, retrospective and comparative study, between two groups: advanced maternal age group (aged ≥ 35 years) and non-advanced maternal age group (age < 35 years), conducted between March and June 2015. Chi-square test and Fisher's exact test were used and considered significant if p < 0.05.
Of the 736 women admitted to the hospital (32.2% with advanced maternal age), 306 were included in the study (153 in each group). In the non-advanced maternal age group there was a greater number of primiparous women (p < 0.01). In the advanced maternal age group, more previous miscarriages were observed (p < 0.001), as well as a higher use of assisted reproductive techniques (p < 0.01), preformed of amniocentesis (p < 0.001) and dystocia, including caesarean sections (p < 0.001). No association was found regarding the presence of maternal complications in pregnancy, birth defects, need for neonatal resuscitation or prematurity. As for the perception of risk in pregnancy, the non-advanced maternal age group considered it to be superior (p < 0.05).
Most women of advanced maternal age have term deliveries without complications. Neonatal outcomes seem not to have been influenced by the advanced maternal age.
The consequences of an advanced maternal age pregnancy in this sample did not have the same clinical expression as described in the literature. In the future, advanced maternal age will possibly be considered after age 40.
高龄产妇定义为35岁之后生育，与孕期及新生儿期更多并发症以及生育力下降相关。本研究旨在探讨高龄产妇与其母婴结局之间的关系，以及产妇对35岁之后妊娠风险的认知。
2015年3月至6月间进行的观察性、回顾性和对比性研究，分为两组：高龄产妇组（年龄≥35岁）和非高龄产妇组（年龄<35岁）。采用卡方检验和费舍尔精确检验，p<0.05则认为具有显著性。
在736名入院女性中（32.2%为高龄产妇），306名纳入研究（每组153名）。非高龄产妇组初产妇数量更多（p<0.01）。在高龄产妇组中，观察到更多既往流产情况（p<0.001），以及更高的辅助生殖技术使用率（p<0.01）、羊水穿刺实施率（p<0.001）和难产率，包括剖宫产率（p<0.001）。在孕期母体并发症、出生缺陷、新生儿复苏需求或早产方面未发现关联。至于对妊娠风险的认知，非高龄产妇组认为风险更高（p<0.05）。
大多数高龄产妇足月分娩且无并发症。新生儿结局似乎未受高龄产妇影响。
本样本中高龄产妇妊娠的后果与文献中描述的临床表现不同。未来，高龄产妇可能会考虑定义为40岁之后。
