Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Xiamen Diabetes Prevention and Treatment Center, Fujian Key Laboratory of Diabetes Translational Medicine, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, Fujian, China.
The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China.
BMC Public Health. 2023 Feb 14;23(1):326. doi: 10.1186/s12889-023-15235-4.
Advanced maternal age (AMA; ≥35 years) is considered to be a major risk factor for adverse pregnancy outcomes. Along with the global trend of delayed childbearing, and in particular, the implementation of China's second and third-child policy leading to a dramatic increase of AMA in recent years, the association between maternal age and pregnancy outcomes requires more investigation.
A population-based retrospective study was performed. Data were derived from the Medical Birth Registry of Xiamen from 2011 to 2018. Univariate and multivariate logistic regression was used to evaluate the effects of maternal age on pregnancy outcomes.
A total of 63,137 women categorized into different age groups (< 25 years, 25-29 years, 30-34 years, and ≥ 35 years) were included in this study. Compared with the mothers aged 25-29 years, the univariate regression analysis showed that mothers aged < 25 years had lower risks of gestational diabetes mellitus (GDM) and cesarean. AMA was associated with higher risks of GDM, hypertension, cesarean, preterm birth, low-birth weight (LBW), large-for-gestational-age (LGA), macrosomia, and stillbirth (all P < 0.01). After adjustment for potential confounding factors, increased risks of GDM, hypertension, cesarean, preterm birth, and LBW remained significantly associated with AMA (all P < 0.05), whereas AMA mothers showed a lower risk of macrosomia than their younger counterparts. Additionally, no significant differences were detected in terms of Apgar score < 7.
AMA was associated with adverse pregnancy outcomes including increased risks of GDM, hypertension, cesarean, preterm birth, and LBW. This study confirmed the relationship between AMA and certain adverse maternal and fetal outcomes and emphasizes the necessity for women to be cautious about the age at which they become pregnant.
高龄产妇（AMA；≥35 岁）被认为是不良妊娠结局的主要危险因素。随着全球生育年龄推迟的趋势，特别是中国实施二孩和三孩政策导致近年来 AMA 急剧增加，因此需要更多研究母亲年龄与妊娠结局之间的关系。
进行了一项基于人群的回顾性研究。数据来自 2011 年至 2018 年厦门的医疗生育登记。采用单因素和多因素逻辑回归来评估母亲年龄对妊娠结局的影响。
共有 63137 名女性分为不同年龄组（<25 岁、25-29 岁、30-34 岁和≥35 岁）纳入本研究。与 25-29 岁的母亲相比，单因素回归分析显示，年龄<25 岁的母亲患妊娠期糖尿病（GDM）和剖宫产的风险较低。AMA 与 GDM、高血压、剖宫产、早产、低出生体重（LBW）、巨大儿（LGA）、巨大儿、死胎的风险增加有关（均 P<0.01）。调整潜在混杂因素后，GDM、高血压、剖宫产、早产和 LBW 与 AMA 仍显著相关（均 P<0.05），而 AMA 母亲发生巨大儿的风险低于年轻母亲。此外，两组间的 Apgar 评分<7 无显著差异。
AMA 与不良妊娠结局相关，包括 GDM、高血压、剖宫产、早产和 LBW 的风险增加。本研究证实了 AMA 与某些不良母婴结局之间的关系，并强调了女性在考虑怀孕时应谨慎选择年龄。
