Homerton Fertility Centre, Homerton University Hospital, Homerton Row, Clapton, London, E9 6SR, UK.
Homerton Fertility Centre, Homerton University Hospital, Homerton Row, Clapton, London, E9 6SR, UK.
Best Pract Res Clin Obstet Gynaecol. 2021 Jan;70:28-50. doi: 10.1016/j.bpobgyn.2020.11.003. Epub 2020 Nov 27.
Pregnancies at an advanced reproductive age are increasingly common. However, the safety of pregnancy remains a concern as maternal age is a recognized independent factor for various obstetric complications. Also, age is a risk factor for most systematic health problems and older women are more likely to enter into pregnancy with pre-existing conditions. At the moment there is no separate, structured guidance on preconception tests at advanced maternal age. However, the preconceptual period offers an ideal window to recognize and address underlying health issues, social issues and harmful lifestyle behaviours in order to optimize maternal health ultimately reducing infertility, perinatal morbidity and mortality. Preconception tests should be clinically relevant aiming to identify risk factors and address them to predict and prevent infertility and pregnancy complications. The importance of preconception care is magnified for women of advanced age for whom the risks are higher and the potential benefits greater.
高龄妊娠越来越常见。然而,由于年龄是各种产科并发症的公认独立因素,妊娠的安全性仍然令人担忧。此外,年龄是大多数系统性健康问题的危险因素,老年妇女更有可能在患有既往疾病的情况下怀孕。目前,针对高龄产妇的孕前检查尚无单独的、结构化的指导意见。然而,孕前阶段是一个理想的窗口期,可以识别和解决潜在的健康问题、社会问题和不良生活方式行为,从而优化产妇健康,最终降低不孕、围产期发病率和死亡率。孕前检查应该具有临床相关性,旨在识别风险因素并加以解决,以预测和预防不孕和妊娠并发症。对于高龄妇女来说,孕前保健的重要性更为突出,因为她们的风险更高,潜在的益处也更大。