Department of Gynaecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
Sci Rep. 2018 Aug 16;8(1):12239. doi: 10.1038/s41598-018-29889-3.
This retrospective cohort study attempts to investigate pregnancy complications and adverse pregnancy outcomes in women of advanced maternal age (AMA). Data were extracted from electronic medical records system at West China Second University Hospital of Sichuan University from January 2013 to July 2016. The study cohort consisted 8 subgroups of women on 4 different age levels (20-29 years, 30-34 years, 35-39 years and ≥40 years) and 2 different parities (primiparity and multiparity). In the study period, 38811 women gave birth at our hospital, a randomized block was used to include 2800 women of singleton pregnancy >28 gestational weeks, with 350 patients in each subgroup. Maternal complications and fetal outcomes were collected and defined according to relevant guidelines. Confounding factors representing maternal demographic characteristics were identified from previous studies and analysed in multivariate analysis. There was an increasing trend for the risks of adverse pregnancy outcomes with increasing age, especially in AMA groups. Our study showed that AMA, primiparity, maternal overweight or obesity, lower educational level and residence in rural area increased pregnancy complications and adverse fetal outcomes. Increased professional care as well as public concern is warranted.
本回顾性队列研究旨在探讨高龄产妇（AMA）的妊娠并发症和不良妊娠结局。数据从 2013 年 1 月至 2016 年 7 月从四川大学华西第二医院电子病历系统中提取。研究队列由 4 个不同年龄组（20-29 岁、30-34 岁、35-39 岁和≥40 岁）和 2 个不同产次（初产妇和经产妇）的 8 个亚组的妇女组成。在研究期间，我院有 38811 名妇女分娩，采用随机分组法纳入 2800 名孕 28 周以上的单胎妊娠妇女，每个亚组 350 例。根据相关指南收集并定义了母亲并发症和胎儿结局。混杂因素代表母亲的人口统计学特征，从先前的研究中确定并在多变量分析中进行了分析。随着年龄的增长，不良妊娠结局的风险呈上升趋势，尤其是在 AMA 组。我们的研究表明，AMA、初产妇、母亲超重或肥胖、较低的教育水平和农村地区居住会增加妊娠并发症和不良胎儿结局。需要增加专业护理和公众关注。
