Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland.
Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children's Hospital, 15-274 Bialystok, Poland.
Int J Environ Res Public Health. 2022 Jan 26;19(3):1384. doi: 10.3390/ijerph19031384.
Despite numerous studies of women having children later in life, evidence of the relationship between maternal factors and newborn outcomes in Central and Eastern European countries is limited. This study aimed to examine the association between maternal age, biological determinants, including parity and sex of the newborn, demographic and social background, and birth weight in 3.8 million singleton live births in Poland.
The effect of maternal age on birth weight (in grams and Z-scores) adjusted for confounders was assessed using Generalized Linear Models.
The mean (±SD) birth weights of neonates born to primiparous women and multiparous women were 3356.3 ± 524.9 g and 3422.7 ± 538.6 g, respectively, which corresponded to a Z-score of -0.07 ± 0.96 and 0.14 ± 1.00, respectively ( ≤ 0.001). After controlling for biological, demographic, and social factors, a significant decrease in birth weight was found for primiparous women of the age group ≥30 years and multiparous women aged ≥35 years compared to the age group of 25-29 years. The lowest neonatal birth weight was observed in the case of women aged ≥45 years. Confounders did not affect birth weight Z-scores among primiparous women, whereas among multiparous women, together with educational factors, they reversed Z-scores from positive to negative values. The lower birth weight of neonates was overall associated with lower maternal education.
Regardless of parity, advanced maternal age is strongly associated with a decreased neonatal birth weight, implying complications in early pregnancy and the antenatal period as well as obstetric complications. Counseling to support women's family planning decisions and improving women's education during their reproductive age may help to alleviate unfavorable newborn outcomes.
尽管有许多关于女性晚育的研究，但中欧和东欧国家关于产妇因素与新生儿结局之间关系的证据有限。本研究旨在探讨波兰 380 万例单胎活产中产妇年龄、生物学决定因素（包括产次和新生儿性别）、人口统计学和社会背景与出生体重之间的关系。
使用广义线性模型评估校正混杂因素后产妇年龄对出生体重（克和 Z 评分）的影响。
初产妇和经产妇新生儿的平均（±SD）出生体重分别为 3356.3 ± 524.9 克和 3422.7 ± 538.6 克，相应的 Z 评分分别为-0.07 ± 0.96 和 0.14 ± 1.00（≤0.001）。在控制生物学、人口统计学和社会因素后，与 25-29 岁年龄组相比，≥30 岁的初产妇和≥35 岁的经产妇的出生体重显著下降。≥45 岁的妇女新生儿出生体重最低。混杂因素对初产妇的出生体重 Z 评分没有影响，但对经产妇而言，除了教育因素外，它们使 Z 评分从正值变为负值。新生儿出生体重较低总体上与产妇受教育程度较低有关。
无论产次如何，产妇年龄的增加与新生儿出生体重的降低密切相关，这意味着妊娠早期和产前阶段以及产科并发症的复杂性。为支持妇女的计划生育决策提供咨询并在生育年龄提高妇女教育水平，可能有助于缓解不良的新生儿结局。
