Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Computer Science and Engineering, Seoul National University, Seoul, Republic of Korea.
J Perinat Med. 2022 Jan 31;50(4):438-445. doi: 10.1515/jpm-2021-0337. Print 2022 May 25.
To evaluate the effect of maternal age to the cesarean section rate of twin pregnancies in late preterm and term gestation.
A retrospective study was performed on twin pregnancies delivered at Seoul National University Bundang Hospital from June 2003 to December 2020. Preterm births before 34 weeks of gestation were excluded, and only live births were analyzed. The patients were classified into four groups according to maternal age (<30, 30-34, 35-39, and ≥40 years). The primary outcome was the rate of cesarean section.
The median value of maternal body mass index, the rate of assisted reproductive technology, dichorionic twin pregnancy, preeclampsia, and gestational diabetes increased significantly according to the maternal age group (all p<0.05). Among a total of 2,075 twin pregnancies, the rates of cesarean section were 65, 74, 80, and 95% for groups with maternal age under 30, 30-34, 35-39, and ≥40 years, respectively (p<0.001). The cesarean section rates after a trial of labor were 22, 22, 28, and 63%, respectively (p=0.032). Maternal old age was an independent risk factor for cesarean section after a trial of labor in both nulliparous and multiparous women after adjusting for confounding factors.
The rate of cesarean section in twin pregnancies significantly increased as maternal age increased, even in multiparous women.
评估母亲年龄对晚期早产和足月双胎剖宫产率的影响。
对 2003 年 6 月至 2020 年 12 月在首尔国立大学盆唐医院分娩的双胎妊娠进行回顾性研究。排除妊娠 34 周前的早产病例，仅分析活产儿。根据母亲年龄（<30 岁、30-34 岁、35-39 岁和≥40 岁）将患者分为四组。主要结局为剖宫产率。
随着母亲年龄组的增加，母体体重指数的中位数、辅助生殖技术的比例、双绒毛膜双胞胎妊娠、子痫前期和妊娠期糖尿病的发生率显著增加（均 p<0.05）。在总共 2075 例双胎妊娠中，母亲年龄<30 岁、30-34 岁、35-39 岁和≥40 岁的剖宫产率分别为 65%、74%、80%和 95%（p<0.001）。试产成功后的剖宫产率分别为 22%、22%、28%和 63%（p=0.032）。调整混杂因素后，母亲高龄是初产妇和经产妇试产失败后行剖宫产的独立危险因素。
即使是经产妇，随着母亲年龄的增加，双胎妊娠的剖宫产率也显著增加。
