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高龄产妇与妊娠:可行但存在问题的事件。

Advanced maternal age (AMA) and pregnancy: a feasible but problematic event.

机构信息

Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000, Belgrade, Serbia.

Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, Dr Koste Todorovića 26, 11000, Belgrade, Serbia.

出版信息

Arch Gynecol Obstet. 2024 Sep;310(3):1365-1376. doi: 10.1007/s00404-024-07678-w. Epub 2024 Aug 9.

Abstract

This narrative review aimed to summarize all adverse outcomes of pregnancy in advanced maternal age (AMA) to assess the age of the mother as a potentially crucial risk factor. AMA refers to women older than 35 years. While expectations and the role of women in society have undergone significant changes today, the biology of aging remains unchanged. Various pathologic changes occur in the human body with age, including chronic noncommunicable diseases, as well as notable changes in reproductive organs, that significantly affect fertility. Despite substantial advancements in technology and medicine, pregnancy in AMA remains a formidable challenge. Although there are some advantages to postponing childbirth, they primarily relate to maternal maturity and economic stability. However, regrettably, there are also many adverse aspects of pregnancy at advanced ages. These include complications affecting both the mother and the fetus. Pregnants in AMA were more prone to suffer from gestational diabetes mellitus, preeclampsia, and eclampsia during pregnancy compared to younger women. In addition, miscarriages and ectopic pregnancies were more prevalent. Delivery was more frequently completed via cesarean section, and postpartum complications and maternal mortality were also higher. Unfortunately, there were also complications concerning the fetus, such as chromosomal abnormalities, premature birth, low birth weight, admission to the neonatal intensive care unit, and stillbirth.

摘要

本综述旨在总结高龄产妇(AMA)所有妊娠不良结局,以评估母亲年龄作为一个潜在的关键风险因素。AMA 指的是年龄大于 35 岁的女性。尽管今天女性的期望和社会角色发生了重大变化,但衰老的生物学仍然没有改变。随着年龄的增长,人体会发生各种病理变化,包括慢性非传染性疾病,以及生殖器官的显著变化,这些变化会显著影响生育能力。尽管技术和医学取得了重大进展,但 AMA 妊娠仍然是一个巨大的挑战。虽然推迟生育有一些好处,主要与母亲的成熟度和经济稳定性有关,但遗憾的是,高龄妊娠也有许多不利方面。这些包括影响母亲和胎儿的并发症。与年轻女性相比,AMA 孕妇在妊娠期间更易患妊娠糖尿病、子痫前期和子痫。此外,流产和异位妊娠更为常见。分娩更常通过剖宫产完成,产后并发症和产妇死亡率也更高。不幸的是,胎儿也有并发症,如染色体异常、早产、低出生体重、新生儿重症监护病房入住和死产。

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