Ye Xuan, Baker Philip N, Tong Chao
National Clinical Research Center for Child Health and Disorder, Children's Hospital of Chongqing Medical University, Chongqing 401122, China.
State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Fundam Res. 2023 Dec 29;4(6):1719-1728. doi: 10.1016/j.fmre.2023.09.013. eCollection 2024 Nov.
The rising rates of pregnancies associated with advanced maternal age (AMA) have created unique challenges for healthcare systems worldwide. The elevated risk of poor maternal outcomes among AMA pregnancies is only partially understood and hotly debated. Specifically, AMA is associated with reduced fertility and an increased incidence of pregnancy complications. Finding a balance between global fertility policy, socioeconomic development and health care optimization ultimately depends on female fertility. Therefore, there is an urgent need to develop technologies and identify effective interventions. Support strategies should include prepregnancy screening, intervention and postpartum maintenance. Although some reviews have considered the relationship between AMA and adverse pregnancy outcomes, no previous work has comprehensively considered the long-term health effects of AMA on mothers. In this review, we will begin by presenting the current knowledge of global health issues associated with AMA and the effects of advanced age on the female reproductive system, endocrine metabolism, and placental function. We will then discuss physiological alterations, pregnancy complications, and long-term health problems caused by AMA.
高龄孕产妇(AMA)相关妊娠率的上升给全球医疗系统带来了独特挑战。AMA妊娠中孕产妇不良结局风险升高的情况仅得到部分理解且存在激烈争论。具体而言,AMA与生育力下降及妊娠并发症发生率增加有关。在全球生育政策、社会经济发展和医疗保健优化之间找到平衡最终取决于女性生育力。因此,迫切需要开发技术并确定有效的干预措施。支持策略应包括孕前筛查、干预和产后维持。尽管一些综述考虑了AMA与不良妊娠结局之间的关系,但之前没有工作全面考虑过AMA对母亲的长期健康影响。在本综述中,我们将首先介绍与AMA相关的全球健康问题的现有知识,以及高龄对女性生殖系统、内分泌代谢和胎盘功能的影响。然后我们将讨论AMA引起的生理改变、妊娠并发症和长期健康问题。