Mekelle University, College of Health Sciences, P.O. Box 1871, Mekelle, Ethiopia.
Dr. Tewelde Legesse Health Sciences College, P.O. Box 306, Mekelle, Ethiopia.
BMC Pregnancy Childbirth. 2020 Jan 30;20(1):60. doi: 10.1186/s12884-020-2740-6.
Advanced maternal age generally denotes age after 35 years during the time of delivery. Despite the fact that being pregnant at any reproductive age is not risk-free, older gravidity usually culminates with adverse outcomes both to the mother and fetus or neonate. This study aimed to determine the association of adverse obstetrical and perinatal outcomes with advanced maternal age pregnancy. The study was conducted in Ayder comprehensive specialized hospital, north Ethiopia, from 2015 to 2017.
chart review comparative cross-sectional study was employed. Data were retrieved from medical charts of 752 pregnant mothers (376 each for both the study;> 35-year-old and reference group;20-34 year old). Data was collected using a pretested and structured checklist using systematic sampling and data was entered & analyzed using SPSS version 20. Binary and multivariable logistic regression was run to determine the association of independent variables with dependent variables.
This study revealed that advanced maternal age pregnancy was significantly associated with pregnancy induced hypertension [AOR 4.15, 95% CI (2.272-7.575), p < 0.001], ante partum hemorrhage [AOR 2.54, 95% CI (1.32-4.91), P = 0.005] & cesarean delivery [AOR 2.722, 95% CI (1.777-4.170), p < 0.001]. Furthermore, advanced maternal age pregnancy was also increasingly associated with adverse perinatal outcomes like preterm delivery [AOR 3.622, 95% CI (1.469-8.930), p = 0.005], low birth weight [AOR 3.137, 95% CI (1.324-7.433), p = 0.009], perinatal death [AOR 2.54, 95% CI (1.141-5.635), p = 0.022] and low fifth minute APGAR score [AOR 7.507, 95% CI (3.134-17.98), p < 0.001]. Notwithstanding this, maternal age was not found to be associated with amniotic fluid disturbances, premature rupture of membranes and post-term pregnancy.
Advanced maternal age is markedly linked with adverse obstetrical and perinatal outcomes. Therefore, it is better for health care providers to counsel couples, who seek to have a child in their later ages, about the risks of advanced maternal age pregnancy. In addition, health care workers need to emphasize on how to improve advanced age mothers' health through the utilization of contraception to reduce pregnancy in this age group.
高龄产妇通常是指分娩时年龄超过 35 岁的女性。尽管在任何生育年龄怀孕都有风险，但高龄妊娠通常会对母亲和胎儿或新生儿产生不良后果。本研究旨在确定高龄产妇妊娠与不良产科和围产儿结局之间的关系。这项研究是在埃塞俄比亚北部的阿德尔综合专科医院进行的，时间为 2015 年至 2017 年。
采用回顾性比较横断面研究。数据来自 752 名孕妇的病历（研究组和对照组各 376 名；>35 岁和参考组；20-34 岁）。使用经过预测试和结构化检查表，采用系统抽样收集数据，并使用 SPSS 版本 20 输入和分析数据。采用二项和多变量逻辑回归来确定自变量与因变量之间的关系。
本研究表明，高龄产妇妊娠与妊娠高血压[OR 4.15，95%CI（2.272-7.575），p<0.001]、产前出血[OR 2.54，95%CI（1.32-4.91），P=0.005]和剖宫产[OR 2.722，95%CI（1.777-4.170），p<0.001]显著相关。此外，高龄产妇妊娠与不良围产儿结局的相关性也逐渐增加，如早产[OR 3.622，95%CI（1.469-8.930），p=0.005]、低出生体重[OR 3.137，95%CI（1.324-7.433），p=0.009]、围产儿死亡[OR 2.54，95%CI（1.141-5.635），p=0.022]和第五分钟 APGAR 评分低[OR 7.507，95%CI（3.134-17.98），p<0.001]。尽管如此，产妇年龄与羊水紊乱、胎膜早破和过期妊娠无关。
高龄产妇与不良产科和围产儿结局显著相关。因此，医疗保健提供者最好为那些希望在晚年生育的夫妇提供咨询，告知他们高龄产妇妊娠的风险。此外，卫生保健工作者需要强调如何通过利用避孕措施来改善高龄产妇的健康，以减少该年龄段的妊娠。
