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推迟生育——高收入国家中日益普遍但存在风险的趋势。

Delaying Motherhood-An Increasingly Common but Risky Trend in High-Income Countries.

作者信息

Kraus Magdalena, Hartmann Beda, Kirchengast Sylvia

机构信息

Department of Evolutionary Anthropology, University of Vienna, Vienna, Austria.

Clinic Donaustadt, Vienna, Clinic for Gynecology and Obstetrics, Vienna, Austria.

出版信息

Am J Hum Biol. 2025 Apr;37(4):e70037. doi: 10.1002/ajhb.70037.

Abstract

OBJECTIVES

Maternal age at first birth is increasing in most high-income countries. The associations between advanced maternal age and perinatal complications, as well as newborn parameters, were analyzed using a dataset of 6831 singleton births among first-time mothers taking place in Vienna, Austria, between 2010 and 2019.

METHODS

In this single-center medical records-based retrospective study, the following obstetrical parameters have been included: conception mode, preterm birth (< 37th gestational week), labor induction, planned or emergency cesarean sections, adverse child presentation, newborn size, and Apgar scores. The outcomes of first-time mothers older than 35 and 40 years, respectively, were compared to a reference group of first-time mothers aged between 20 and 34 years.

RESULTS

First-time mothers aged 35 and older show a significantly (p < 0.009 resp. p < 0.001) higher risk of preterm births, with a 1.32-fold risk for women between 35 and 39 years and a 2.35-fold risk for women aged 40 and older. Maternal age is also significantly (p < 0.001) associated with an increased rate of medically induced labor, cesarean sections, and low-weight newborns (< 2500 g). In contrast, there was no significant difference in Apgar scores among the newborns of different maternal age groups.

CONCLUSIONS

Advanced maternal age at first birth is a relevant risk factor for certain obstetric and neonatal complications. Delaying motherhood is a risky trend.

摘要

目的

在大多数高收入国家,首次生育时的产妇年龄正在增加。利用2010年至2019年在奥地利维也纳发生的6831例初产妇单胎分娩数据集,分析了高龄产妇与围产期并发症以及新生儿参数之间的关联。

方法

在这项基于单中心医疗记录的回顾性研究中,纳入了以下产科参数:受孕方式、早产(<第37孕周)、引产、计划或急诊剖宫产、不良胎儿胎位、新生儿大小和阿氏评分。分别将35岁及以上和40岁及以上初产妇的结局与年龄在20至34岁之间的初产妇参考组进行比较。

结果

35岁及以上的初产妇早产风险显著更高(分别为p<0.009和p<0.001),35至39岁女性的风险为1.32倍,40岁及以上女性的风险为2.35倍。产妇年龄也与医学引产、剖宫产和低体重新生儿(<2500g)的发生率显著增加相关(p<0.001)。相比之下,不同产妇年龄组新生儿的阿氏评分没有显著差异。

结论

首次生育时的高龄产妇是某些产科和新生儿并发症的相关危险因素。推迟生育是一种有风险的趋势。

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