Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan.
Sci Rep. 2023 Aug 9;13(1):12918. doi: 10.1038/s41598-023-40150-4.
This study aimed to clarify the relationship between maternal mortality and advanced maternal age in Japan and to provide useful information for future perinatal management. Maternal death rates by age group were investigated for all maternal deaths in Japan for an 11-year period, from 2010 to 2021. Maternal deaths among those aged ≥ 40 years were examined in detail to determine the cause, and the number of deaths by cause was calculated. The causes of onset of the most common causes of death were also investigated. The maternal mortality rates were 0.8 (95% confidence interval [CI] 0.3-4.7) for < 20 years, 2.6 (95% CI 1.7-3.8) for 20-24 years, 2.9 (95% CI 2.3-3.6) for 25-29 years, 3.9 (95% CI 3.3-4.5) for 30-34 years, 6.8 (95% CI 5.9-7.9) for 35-39 years, and 11.2 (95% CI 8.8-14.3) for ≥ 40 years of age. Patients who were ≥ 40 years of age had a significantly higher mortality rate compared to that in other age groups. Hemorrhagic stroke was the most common cause of death in patients aged ≥ 40 years (15/65 [23%]), and preeclampsia (8/15 [54%]) was the most common cause of hemorrhagic stroke. Maternal mortality is significantly higher in older than in younger pregnant women in Japan, with hemorrhagic stroke being the most common cause of maternal death among women > 40 years of age. More than half of hemorrhagic strokes are associated with hypertension disorder of pregnancy. These facts should be considered by women who become pregnant at an advanced age and by healthcare providers involved in their perinatal care.
本研究旨在阐明日本产妇死亡与高龄产妇之间的关系，为未来围产期管理提供有用信息。对 2010 年至 2021 年期间日本所有产妇死亡的年龄组别产妇死亡率进行了调查。详细检查了≥40 岁产妇死亡的原因，并计算了各病因的死亡人数。还调查了最常见死因发病的原因。产妇死亡率为<20 岁 0.8（95%置信区间 [CI] 0.3-4.7），20-24 岁 2.6（95% CI 1.7-3.8），25-29 岁 2.9（95% CI 2.3-3.6），30-34 岁 3.9（95% CI 3.3-4.5），35-39 岁 6.8（95% CI 5.9-7.9），≥40 岁 11.2（95% CI 8.8-14.3）。与其他年龄组相比，≥40 岁的患者死亡率显著更高。出血性中风是≥40 岁患者死亡的最常见原因（65 例中的 15 例 [23%]），子痫前期（8/15 [54%]）是出血性中风最常见的病因。日本高龄产妇的产妇死亡率明显高于年轻产妇，≥40 岁产妇死亡的最常见原因是出血性中风。超过一半的出血性中风与妊娠高血压疾病有关。这些事实应引起高龄妊娠妇女和参与其围产期保健的保健提供者的重视。
