Juneja Sunil Kumar, Tandon Pooja, Kaur Gagandeep
Department of Obstetrics and Gynaecology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Int J Appl Basic Med Res. 2022 Oct-Dec;12(4):239-242. doi: 10.4103/ijabmr.ijabmr_193_22. Epub 2022 Dec 19.
Late pregnancies have been a sensitive issue in the society and medical field for many years. The reason for this development could be the increasing use of reproductive techniques, women empowerment and late conceptions. The increased level of education in women, having more responsibilities at work, giving priority to their professional career could be leading to delay in conception and childbearing. Many studies have investigated the effect of advanced maternal age on fetal outcome suggesting higher risk of poor neonatal outcome. Recent studies have debated these outcomes.[1234].
To evaluate the effect of increasing maternal age on maternal and neonatal outcomes in pregnancies at advanced maternal age.
The study was conducted on 843 women above the age of 35 years who delivered at Dayanand Medical College and Hospital during 2015-2020. Patients were categorized into 2 groups, Group A comprised of pregnant women aged 35-40 years; group B included pregnant women aged >40 years. Various other parameters including parity, gestation at delivery, whether the pregnancies were spontaneous or conceived through ART (assisted reproductive techniques) and other associated co-morbid conditions were noted. The obstetrical, gynecological, medical, surgical, fetal and neonatal complications were studied in both the groups and the data was analyzed with release 9.4 (SAS Institute Inc, Cary, NC).
Out of 843 patients in our study, 81.4% (n=687) belonged to the age group of 35- 40 years. 18.5% (n=156) belonged to the age group of > 40 years. Patients more than 40 years underwent ART for conception more often as compared to group A. Co-morbid medical conditions including chronic hypertension, thyroid diseases, auto immune disorders and obstetric complications such as abortions, oligohydramnios, GDM, placenta previa, PPH was significantly more common in patients with group B. Cesarean delivery rate was significantly more in group B as compared to group A. Neonatal outcome in terms of NICU admissions and preterm birth at less than 35 weeks gestation was seen more frequently in group B as compared to Group A.
Our study concludes that the decision to delay childbearing should be discouraged owing to increased maternal and fetal morbidity associated with advanced maternal age, the risks being higher with increasing maternal age.
多年来，晚育在社会和医学领域一直是一个敏感问题。这种情况发展的原因可能是生殖技术的使用增加、女性赋权以及受孕时间推迟。女性受教育程度提高、工作中承担更多责任、优先考虑职业生涯可能导致受孕和生育延迟。许多研究调查了高龄产妇对胎儿结局的影响，表明新生儿结局不良的风险更高。最近的研究对这些结果进行了辩论。[1234]
评估高龄产妇年龄增加对高龄产妇妊娠中母婴结局的影响。
该研究对2015年至2020年期间在戴亚南德医学院及医院分娩的843名35岁以上女性进行。患者分为两组，A组为年龄在35至40岁的孕妇；B组包括年龄大于40岁的孕妇。记录了各种其他参数，包括产次、分娩时的孕周、妊娠是自然受孕还是通过辅助生殖技术（ART）受孕以及其他相关合并症。对两组的产科、妇科、内科、外科、胎儿和新生儿并发症进行了研究，并使用9.4版（SAS Institute Inc，卡里，北卡罗来纳州）对数据进行了分析。
在我们研究的843名患者中，81.4%（n = 687）属于35至40岁年龄组。18.5%（n = 156）属于年龄大于40岁年龄组。与A组相比，40岁以上的患者更常通过辅助生殖技术受孕。B组患者中，包括慢性高血压、甲状腺疾病、自身免疫性疾病等合并内科疾病以及流产、羊水过少、妊娠期糖尿病、前置胎盘、产后出血等产科并发症明显更为常见。与A组相比，B组剖宫产率明显更高。与A组相比，B组在新生儿重症监护病房（NICU）入院和孕周小于35周的早产方面的新生儿结局更为常见。
我们的研究得出结论，由于高龄产妇相关的母婴发病率增加，且随着产妇年龄增加风险更高，应不鼓励推迟生育的决定。
