Trotman Helen, Samms-Vaughan Maureen, Coore-Desai Charlene, Reece Jody-Ann, Olugbuyi Oluwayomi
Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies, Mona, St. Andrew, Jamaica.
Am J Perinatol. 2023 Apr;40(6):619-623. doi: 10.1055/s-0041-1730350. Epub 2021 May 27.
The study aimed to determine the outcome of babies born to women ≥40 years in a Jamaican birth cohort.
Maternal demographic data and neonatal data for women ≥40 years who delivered live singleton babies and their younger counterparts aged 20 30 years were extracted from the JA KIDS birth cohort dataset. Outcome measures were preterm birth, low birth weight, very low birth weight, extremely low birth weight, macrosomia, a low 5-minute Apgar score <7, admission to the neonatal unit, and neonatal death. Descriptive analyses were performed; statistical significance was taken at the level <0.05.
A total of 5,424 women and their babies were entered into the study, 5,099 (94%) women were aged 20 to 30 years (mean age ± standard deviation [SD]: 24.5 ± 3.2 years) and 325 (6%) were aged ≥40 years (mean age ± SD: 41.5 ± 1.6 years). A greater percentage of preterm babies (18%) were born to women ≥40 years than to their younger counterparts (14%; = 0.04). There was no difference in the proportion of low birth weight infants, very low birth weight infants, or extremely low birth weight infants born between the two groups ( > 0.05). There was also no significant difference in the proportion of babies who were macrosomic and in those who had a low 5-minute Apgar score <7. There were 866 (16%) neonatal admissions, 67/325 (21%) of these babies were born to women aged ≥40 years and 799/5,099 (16%) were born to their younger counterparts ( = 0.01). The commonest reason for admission was prematurity. While 60 babies died, there was no significant difference between both groups with 56 (1%) born to women 20 to 30 years and 4 (1%) born to women ≥40 years ( = 0.48).
Adverse outcomes noted for babies born to women ≥40 years were prematurity and the need for neonatal admission. However, no excess mortality was recorded.
· Women 40 years and older are more likely to have a chronic illness such as hypertension and diabetes and to have an operative delivery.. · Babies born to women 40 years and older are more likely to be late premature infants and require neonatal admission.. · However, there is no increased risk of neonatal mortality..
本研究旨在确定牙买加出生队列中40岁及以上女性所生孩子的结局。
从牙买加儿童出生队列数据集中提取分娩单胎活婴的40岁及以上女性及其20至30岁的年轻对应女性的产妇人口统计学数据和新生儿数据。结局指标包括早产、低出生体重、极低出生体重、超低出生体重、巨大儿、5分钟阿氏评分<7、入住新生儿病房以及新生儿死亡。进行描述性分析；统计学显著性水平设定为<0.05。
共有5424名女性及其婴儿纳入研究，其中5099名（94%）女性年龄在20至30岁之间（平均年龄±标准差[SD]：24.5±3.2岁），325名（6%）女性年龄在40岁及以上（平均年龄±SD：41.5±1.6岁）。40岁及以上女性所生孩子中早产的比例（18%）高于年轻对应女性（14%；P = 0.04）。两组之间低出生体重儿、极低出生体重儿或超低出生体重儿的比例没有差异（P>0.05）。巨大儿和5分钟阿氏评分<7的婴儿比例也没有显著差异。共有866名（16%）新生儿入住新生儿病房，其中67/325名（21%）婴儿的母亲年龄在40岁及以上，799/5099名（16%）婴儿的母亲为年轻对应女性（P = 0.01）。入住的最常见原因是早产。虽然有60名婴儿死亡，但两组之间没有显著差异，20至30岁女性所生的有56名（1%），40岁及以上女性所生的有4名（1%）（P = 0.48）。
40岁及以上女性所生孩子的不良结局为早产和需要入住新生儿病房。然而，未记录到额外的死亡率。
·40岁及以上的女性更有可能患有高血压和糖尿病等慢性疾病，并且更有可能接受手术分娩。·40岁及以上女性所生孩子更有可能是晚期早产儿，需要入住新生儿病房。·然而，新生儿死亡率没有增加。
