title: Is there an incremental rise in the risk of obstetric intervention with increasing maternal age?
abstract: OBJECTIVE
  To determine whether increasing maternal age increases the risk of operative delivery and to investigate whether such a trend is due to fetal or maternal factors. DESIGN ANALYSIS: of prospectively collected data on a maternity unit database.
  
  
  METHODS
  A postgraduate teaching hospital.
  
  
  METHODS
  6410 nulliparous women with singleton cephalic pregnancies delivering at term (3742 weeks of gestation) between 1 January 92 and 31 December 95.
  
  
  METHODS
  Mode of delivery, rates of prelabour caesarean section, induction of labour and epidural usage.
  
  
  RESULTS
  There was a positive, highly significant association between increasing maternal age and obstetric intervention. Prelabour (P < 0.001) and emergency (P < 0.001) caesarean section, instrumental vaginal delivery (spontaneous labour P < 0001; induced labour P = 0.001), induction of labour (P < 0.001) and epidural usage in spontaneous labour (P = 0.005) all increased with increasing age. In the second stage of labour fetal distress and failure to advance, requiring instrumental delivery, were both more likely with increasing maternal age (in both P < 0.001). Epidural usage in induced labour and the incidence of small for gestational age newborns did not increase with increasing maternal age (P = 0.68 and P = 0.50, respectively).
  
  
  CONCLUSIONS
  This study demonstrates that increasing maternal age is associated with an incremental increase in obstetric intervention. Previous studies have demonstrated a significant effect in women older than 35 years of age, but these data show changes on a continuum from teenage years. This finding may reflect a progressive, age-related deterioration in myometrial function.
authors.affiliation: Queen Charlotte's and Chelsea Hospital for Women, London, UK.
authors.forename: A N
authors.initials: AN
authors.lastname: Rosenthal
authors.forename: S
authors.initials: S
authors.lastname: Paterson-Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000767:Anesthesia, Epidural / Q000706:statistics & numerical data; D000773:Anesthesia, Obstetrical / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D002648:Child; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data*; D005113:Extraction, Obstetrical / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008423:Maternal Age; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000628:therapy*; D011247:Pregnancy; D011446:Prospective Studies