Bekele Gemechu Gelan, Yohannes Roga Ephrem, Gonfa Dajane Negesse, Yami Amare Tesfaye, Fekene Daniel Belema, Kabale Wogene Daro
Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
SAGE Open Med. 2023 Sep 29;11:20503121231201282. doi: 10.1177/20503121231201282. eCollection 2023.
Pregnancy in women over the age of 35 years is considered advanced maternal age. The relationship between advanced maternal age and the risk of perinatal mortality is still controversial. As a result, this systematic review and meta-analysis were carried out to clarify the relationship between advanced maternal age and perinatal mortality in Ethiopia.
The following electronic databases were used for this systematic review and meta-analysis: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, HINARI, and African Journals Online up to March 2022. Addis Ababa, Gondor, and Jimma University research repositories were also searched. A random-effects model was used to pool study-specific odds ratios.
A total of 18 articles, including a total of 45,541 participants, were included in the meta-analysis. A total of 11 cross-sectional, 2 case-control, and 5 cohort studies were included. The overall pooled estimate indicates that women with advanced maternal age had a 1.58 higher risk of perinatal mortality compared to women in the younger age group (odds ratio = 1.58; 95% Confidence Interval: 1.13-2.03). The subgroup analysis also revealed that there were differences in the effect size as the geographical region differed. The result showed that the odd of perinatal mortality was highest in the Oromia region and lowest in the Southern Nations Nationalities and Peoples' Region.
The overall pooled estimate indicates that women with advanced maternal age had a 1.58-fold higher risk of perinatal mortality. Even though this risk could also be increased with other comorbid diseases, it is important for healthcare providers and other concerned stakeholders to be aware of the increased risks associated with advanced maternal age and provide different intervention programs designed to create awareness and provide counseling services to couples who seek to have a child in their later ages about the risks of advanced maternal age pregnancy on perinatal mortality and other adverse pregnancy outcomes.
35岁以上女性怀孕被视为高龄孕产妇。高龄孕产妇与围产期死亡率之间的关系仍存在争议。因此，开展了这项系统评价和荟萃分析，以阐明埃塞俄比亚高龄孕产妇与围产期死亡率之间的关系。
本系统评价和荟萃分析使用了以下电子数据库：截至2022年3月的PubMed、科学网、Scopus、Science Direct、谷歌学术、HINARI和非洲期刊在线。还检索了亚的斯亚贝巴大学、贡德尔大学和吉姆马大学的研究知识库。采用随机效应模型汇总各研究的比值比。
荟萃分析共纳入18篇文章，包括45541名参与者。共纳入11项横断面研究、2项病例对照研究和5项队列研究。总体汇总估计表明，与年轻年龄组的女性相比，高龄孕产妇围产期死亡风险高1.58倍（比值比=1.58；95%置信区间：1.13-2.03）。亚组分析还显示，随着地理区域的不同，效应大小存在差异。结果表明，奥罗米亚地区围产期死亡几率最高，而南方民族和人民地区最低。
总体汇总估计表明，高龄孕产妇围产期死亡风险高1.58倍。尽管其他合并症也可能增加这种风险，但医疗保健提供者和其他相关利益攸关方必须意识到与高龄孕产妇相关的风险增加，并提供不同的干预方案，以提高认识，并为寻求晚育的夫妇提供咨询服务，告知他们高龄孕产妇怀孕对围产期死亡率和其他不良妊娠结局的风险。
