Impact of maternal age on obstetric outcome.
OBJECTIVE
To estimate the effect of maternal age on obstetric outcomes.


METHODS
A prospective database from a multicenter investigation of singletons, the FASTER trial, was studied. Subjects were divided into 3 age groups: 1) less than 35 years, 2) 35-39 years, and 3) 40 years and older. Multivariable logistic regression analysis was used to assess the effect of age on outcomes after adjusting for race, parity, body mass index, education, marital status, smoking, medical history, use of assisted conception, and patient's study site.


RESULTS
A total of 36,056 women with complete data were available: 28,398 (79%) less than 35 years of age; 6,294 (17%) 35-39 years; and 1,364 (4%) 40 years and older. Increasing age was significantly associated with miscarriage (adjusted odds ratio [adjOR]2.0 and 2.4 for ages 35-39 years and age 40 years and older, respectively), chromosomal abnormalities (adjOR 4.0 and 9.9), congenital anomalies (adjOR 1.4 and 1.7), gestational diabetes (adjOR 1.8 and 2.4), placenta previa (adjOR 1.8 and 2.8), and cesarean delivery (adjOR 1.6 and 2.0). Patients aged 35-39 years were at increased risk for macrosomia (adjOR 1.4). Increased risk for abruption (adjOR 2.3), preterm delivery (adjOR 1.4), low birth weight (adjOR 1.6), and perinatal mortality (adjOR 2.2) was noted in women aged 40 years and older.


CONCLUSIONS
Increasing maternal age is independently associated with specific adverse pregnancy outcomes. Increasing age is a continuum rather than a threshold effect.
Cleary-Goldman
Jane
J
Columbia University Medical Center, New York, New York, USA. jec32@columbia.edu
Malone
Fergal D
FD
Vidaver
John
J
Ball
Robert H
RH
Nyberg
David A
DA
Comstock
Christine H
CH
Saade
George R
GR
Eddleman
Keith A
KA
Klugman
Susan
S
Dugoff
Lorraine
L
Timor-Tritsch
Ilan E
IE
Craigo
Sabrina D
SD
Carr
Stephen R
SR
Wolfe
Honor M
HM
Bianchi
Diana W
DW
D'Alton
Mary
M
D000328:Adult; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007743:Labor, Obstetric; D016015:Logistic Models; D008423:Maternal Age; D015337:Multicenter Studies as Topic; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth; D011336:Probability; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D014481:United States