title: Pregnancy at or beyond age 40 years is associated with an increased risk of fetal death and other adverse outcomes.
abstract: OBJECTIVE
  The objective of the study was to determine the frequency of fetal death in women 40 years of age or older (AMA).
  
  
  METHODS
  Retrospective study of all singleton pregnancies delivered at our institution between the years 1989 and 2004 was performed. The primary outcome measure was the risk of fetal death at various gestational ages. We also investigated the frequency of maternal comorbidities, preterm delivery (PTD), and low and very low birth weights (LBW, VLBW).
  
  
  RESULTS
  Data were available for 126,402 singleton deliveries. AMA was an independent risk factor for fetal death at 28-31 weeks (adjusted odds ratio [AOR] 2.93, 95% confidence interval [CI] 1.76-4.92), 32-36 (AOR 1.73, 95% CI 1.05-2.83), 37-39 weeks (AOR 1.63, 95% CI 0.97-2.75), and 40-41 weeks (AOR 2.28, 95% CI 1.18-4.4). AMA was associated with increased rates of PTD, LBW, and VLBW.
  
  
  CONCLUSIONS
  AMA is associated with an increased rate of fetal death and other adverse obstetrical outcomes. Antepartum fetal surveillance may be warranted in these women.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, FL 33101, USA.
authors.forename: M Camille
authors.initials: MC
authors.lastname: Hoffman
authors.forename: Sarah
authors.initials: S
authors.lastname: Jeffers
authors.forename: Jena
authors.initials: J
authors.lastname: Carter
authors.forename: Lunthita
authors.initials: L
authors.lastname: Duthely
authors.forename: Amanda
authors.initials: A
authors.lastname: Cotter
authors.forename: Víctor Hugo
authors.initials: VH
authors.lastname: González-Quintero
mesh_terms: D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D012189:Retrospective Studies; D012307:Risk Factors