title: Successful spontaneous pregnancies in women older than 45 years.
abstract: OBJECTIVE
  To characterize the reproductive history of women who delivered an infant after a spontaneous pregnancy after the age of 45 years.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  University departments.
  
  
  METHODS
  Two hundred nine women who conceived spontaneously and had their most recent delivery after the age of 45 years.
  
  
  METHODS
  Review of all individual medical charts for a complete history of all pregnancies.
  
  
  METHODS
  Gravidity, parity, and spontaneous abortion (SAB) rate.
  
  
  RESULTS
  The mean (+/-SD) age at last delivery was 45.7 +/- 0.9 years (range: 45-49). The mean parity was 9.6 +/- 4 children (range: 2-20): 81% of the women were grandmultiparas (> or =6 deliveries) and 46% were grand-grandmultiparas (> or =11 deliveries). The mean number of SAB was 1.9 +/- 1.9 (range: 0-9). Increased parity did not have a protective effect on abortion rate: 12.9% for parity 2-5, 15.6% for parity 6-10, and 21.3% for parity 11-20. Women in the study group differed significantly in their SAB rate from a general population: 11.3% vs. 17.7% at age 39, 13.2% vs. 33.8% at age 44, and 9.1% vs. 33.8% at age 45.
  
  
  CONCLUSIONS
  Women who conceived at or after 45 years of age were mostly grandmultiparas. Although multiparity in itself did not affect SAB rates, this measure was remarkably low in our exceptionally fertile group as compared with the rates published for a general population. This unique group of grandmultiparous women might possess a genetic propensity that delays the normal rate of ovarian and oocyte senescence.
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah University Medical Center, The Hebrew University, Jerusalem, Israel. neri@cc.huji.ac.il
authors.forename: Neri
authors.initials: N
authors.lastname: Laufer
authors.forename: Alex
authors.initials: A
authors.lastname: Simon
authors.forename: Arnon
authors.initials: A
authors.lastname: Samueloff
authors.forename: Haim
authors.initials: H
authors.lastname: Yaffe
authors.forename: Ariel
authors.initials: A
authors.lastname: Milwidsky
authors.forename: Yuval
authors.initials: Y
authors.lastname: Gielchinsky
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000782:Aneuploidy; D004314:Down Syndrome / Q000453:epidemiology; D005260:Female; D006801:Humans; D008423:Maternal Age; D008875:Middle Aged; D010298:Parity; D018566:Pregnancy, High-Risk