Mansfield P K
Women Health. 1986 Summer;11(2):37-60. doi: 10.1300/J013v11n02_04.
A critical review of the scientific literature linking advanced maternal age to eight adverse pregnancy outcomes commonly believed to increase with advancing age revealed little support for the pessimistic medical view that late childbearing is necessarily riskier. Most studies (61% of the 104 studies reviewed) were seriously flawed methodologically, primarily by confounding age with other factors; many reached conclusions without statistical verification (29% of the studies reviewed). Results concerning the advantages or disadvantages of late childbearing were inconsistent as well. Evidence from the sound research studies strongly suggests that many of the adverse outcomes found by some researchers to increase at an older maternal age may be reflecting the particular circumstances surrounding late childbearing (altered medical management, pre-existing diseases, subfertility, unplanned pregnancy, high parity birth) rather than a biological condition of aging. Further research must move away from looking at maternal age as an isolated variable because of the temptation to impute causality to the factor when other associated factors are not controlled. A better understanding of the reproductive aging process is urgently needed.
对将高龄孕产妇与通常认为会随年龄增长而增加的八项不良妊娠结局联系起来的科学文献进行的批判性综述显示，几乎没有证据支持晚育必然风险更高这一悲观的医学观点。大多数研究（在所审查的104项研究中占61%）在方法上存在严重缺陷，主要是将年龄与其他因素混淆；许多研究在没有统计验证的情况下就得出了结论（在所审查的研究中占29%）。关于晚育利弊的结果也不一致。可靠研究的证据有力地表明，一些研究人员发现的许多在高龄孕产妇中增加的不良结局，可能反映的是晚育周围的特殊情况（医疗管理改变、既往疾病、生育力低下、意外怀孕、多产），而不是衰老的生物学状况。由于在未控制其他相关因素时倾向于将因果关系归因于该因素，进一步的研究必须不再将孕产妇年龄视为一个孤立的变量。迫切需要更好地了解生殖衰老过程。
