Dijon University Hospital, Pôle de Gynécologie-Obstétrique, Médecine Fœtale et Stérilité Conjugale, Dijon F-21000, France.
Dijon University Hospital, Pôle de Gynécologie-Obstétrique, Médecine Fœtale et Stérilité Conjugale, Dijon F-21000, France.
Pregnancy Hypertens. 2019 Oct;18:112-116. doi: 10.1016/j.preghy.2019.09.006. Epub 2019 Oct 3.
The mean age of women delivering for the first time is increasing, and this combination could lead to an increased risk of perinatal complications.
The objective was to evaluate the potential combined effects of nulliparity and increasing maternal age on small for gestational age (SGA < 10th percentile) and hypertensive disorders of pregnancy (HDP).
A population-based cohort study was conducted using data routinely collected on all births in 11 hospitals in the Burgundy perinatal network between 2007 and 2016. Pregnant women with singleton deliveries aged 20 years or older were included at delivery and divided into groups according to maternal age (20 to 24-year-old group as a reference). Multivariate logistic regression models, adjusted on smoking, body mass index, chronic high blood pressure and birth date, were performed.
A total of 137,791 women were included. Whatever the parity, the risks of SGA and HDP increased with maternal age, but the increase began earlier in nulliparous women. Compared to multiparous women, the risk of SGA in nulliparous women increased with maternal age (aOR = 1.5 95% CI [1.4-1.7] for age 20-24 rising to 2.2 [1.8-2.8] for age 40-49). We found evidence that parity modified the association between maternal age and SGA (test for interaction p < 0.001). The risk of HDP was constantly higher in nulliparous women, whatever the maternal age.
The combination of increasing maternal age and nulliparity has a more negative impact on the occurrence of SGA than either risk factor alone.
首次分娩的女性平均年龄不断增加，这可能会增加围产期并发症的风险。
评估初产妇和高龄产妇对小于胎龄儿（SGA < 第 10 百分位）和妊娠高血压疾病（HDP）的潜在联合影响。
采用 2007 年至 2016 年在勃艮第围产期网络的 11 家医院常规收集的所有分娩数据进行了一项基于人群的队列研究。纳入年龄在 20 岁及以上且单胎分娩的孕妇，根据产妇年龄（以 20-24 岁组为参照）分为不同组。进行了多变量逻辑回归模型分析，调整了吸烟、体重指数、慢性高血压和出生日期等因素。
共纳入 137791 名女性。无论初产妇还是经产妇，SGA 和 HDP 的风险均随产妇年龄的增加而增加，但初产妇的风险增加更早。与经产妇相比，初产妇的 SGA 风险随产妇年龄的增加而增加（20-24 岁年龄组的比值比（aOR）=1.5，95%置信区间（CI）为[1.4-1.7]，40-49 岁年龄组为 2.2 [1.8-2.8]）。我们发现，产妇年龄和 SGA 之间的关联存在着交互作用（交互作用检验 p < 0.001）。无论产妇年龄如何，初产妇的 HDP 风险始终更高。
与任何单一风险因素相比，高龄产妇和初产妇的组合对 SGA 的发生有更负面的影响。
