title: Omphalocele, advanced maternal age, and fetal morbidity outcomes.
abstract: In this study we wanted to determine if the risk for adverse neonatal outcome among omphalocele-affected fetuses is increased among older gravidas. This was a retrospective cohort study on live-born infants with omphalocele delivered in New York State from 1983 through 1999. We compared infants of older (>or=35 years) with those of younger (<35 years) mothers with respect to the following fetal morbidity indices: low birth weight and very low birth weight, preterm and very preterm, and small for gestational age. We used adjusted odds ratios to approximate relative risks. Data on a total of 1,010 infants with omphalocele were analyzed. Mean gestational age and birth weight were similar in both maternal age categories: mean+/-standard deviation (SD) for infants with omphalocele born to older mothers=37.4 weeks+/-3.9 versus 38.0 weeks+/-5.1 for those of younger mothers (P=0.2); mean birth weights+/-SD for infants with omphalocele born to older mothers=2,813+/-871.1 versus 2,958+/-809.9 for those of younger mothers (P=0.08). Also, the two maternal age sub-groups did not differ with respect to the fetal morbidity outcome: low birth weight (OR=0.95; 95% CI=0.60-1.51), very low birth weight (OR=0.78; 95% CI=0.36-1.69), preterm (OR=0.95; 95% CI=0.58-1.57), very preterm (OR=0.73; 95% CI=0.34-1.58), and SGA (OR=1.00; 95% CI=0.44-2.27). Thus, advanced maternal age does not appear to be a risk factor for fetal morbidity outcomes among omphalocele-affected fetuses. This information is potentially useful in counseling affected parents.
authors.affiliation: Department of Maternal and Child Health, University of Alabama, Birmingham, Alabama 35294, USA. hsalihu@uab.edu
authors.forename: Hamisu M
authors.initials: HM
authors.lastname: Salihu
authors.forename: Donath
authors.initials: D
authors.lastname: Emusu
authors.forename: Zakari Y
authors.initials: ZY
authors.lastname: Aliyu
authors.forename: Bosny J
authors.initials: BJ
authors.lastname: Pierre-Louis
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Druschel
authors.forename: Russell S
authors.initials: RS
authors.lastname: Kirby
mesh_terms: D000328:Adult; D001724:Birth Weight; D015331:Cohort Studies; D005260:Female; D020567:Fetal Weight; D006554:Hernia, Umbilical / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D009017:Morbidity; D009518:New York / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors