Department of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea.
Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
Sci Rep. 2021 Jan 12;11(1):814. doi: 10.1038/s41598-021-80968-4.
Advanced maternal age (AMA) is a growing trend world-wide and is traditionally defined as childbearing in women over 35 years of age. The purpose of our study was to determine the maternal age group within the Korean population, in which the risk of early neonatal mortality is increased. Korean birth and mortality data from 2011 to 2015 were used to estimate the influence of maternal age on the risk of early neonatal mortality. A Poisson regression was used for the analysis of multiple clinical variables such as year of delivery, maternal age, gestational age, infant gender, birth weight, multiple birth, parity, and socioeconomic variables. Furthermore, a generalized additive model was used to determine the maternal age at which the risk for neonatal mortality increases. We included 2,161,908 participants and found that 49.4% of mothers were 30-34 years of age at delivery. The proportion of mothers aged 35 and above increased over the 5-year analysis period. A maternal age lower than 29 years or higher than 40 years was associated with a relatively higher risk of early neonatal mortality. The trend and magnitude of the age-related risk on early neonatal mortality were independent of maternal socioeconomic factors such as living in an obstetrically underserved area, education level, and employment status. Furthermore, we showed that the risk for early neonatal mortality was higher until the maternal age of 28. However, there were no significant changes in the risk between the age of 35 and 40 years. According to recent national-wide data, age-related risk for early neonatal mortality is only apparent for mothers ≥ 40 years old whereas, age between 35 and 39 are not at increased risk for early neonatal mortality, despite being classified as AMA.
高龄产妇（AMA）是全球范围内日益增长的趋势，传统上定义为 35 岁以上的女性生育。我们的研究目的是确定韩国人群中产妇年龄组，在该年龄组中，早期新生儿死亡的风险增加。我们使用了 2011 年至 2015 年的韩国出生和死亡率数据，以评估产妇年龄对早期新生儿死亡风险的影响。使用泊松回归分析了分娩年份、产妇年龄、胎龄、婴儿性别、出生体重、多胎、产次和社会经济变量等多个临床变量的影响。此外，还使用广义加性模型来确定新生儿死亡率增加的产妇年龄。我们纳入了 2161908 名参与者，发现 49.4%的母亲在分娩时年龄为 30-34 岁。在 5 年的分析期间，35 岁及以上的母亲比例有所增加。年龄低于 29 岁或高于 40 岁的母亲与早期新生儿死亡的风险较高相关。与产妇社会经济因素（如居住在产科服务不足的地区、教育水平和就业状况）无关，年龄相关的早期新生儿死亡风险呈上升趋势且幅度较大。此外，我们还表明，早期新生儿死亡的风险一直较高，直到产妇年龄达到 28 岁。然而，在 35 岁至 40 岁之间，风险没有明显变化。根据最近的全国范围数据，只有年龄在 40 岁及以上的产妇才与早期新生儿死亡的年龄相关风险有关，而年龄在 35 岁至 39 岁之间的产妇则没有增加早期新生儿死亡的风险，尽管被归类为 AMA。
