[Trends in the risk of late fetal mortality, prematurity and low birth weight associated with advanced maternal age in Spain [1996-2005]].
OBJECTIVE
To describe trends in fertility, fetal death rate, prematurity and low birth weight, as well as their association with advanced maternal age, in Spain from 1996 to 2005.


METHODS
We performed an ecological study. The association between low birth weight and prematurity with maternal age was analyzed through contingency tables. The pattern of fetal mortality rate was analyzed through direct standardization. To study the risk of late fetal mortality, adjusted by age and prematurity, a Poisson regression model was used.


RESULTS
The rates of fertility and late fetal mortality increased in women aged more than 35 years, especially in women aged more than 45 years. The risk of late fetal mortality was 2.7 times higher in women aged 45 years and above (rate ratio, 2.7; 95%CI: 1.8-3), with an etiological fraction of exposure of 69% (95%CI: 55.2-78.6). The prevalence rate of prematurity and low birth weight was three times higher in this age group, with a prevalence rate of prematurity of 2.9 (95%CI: 2.7-3.1) and of low birth weight of 3.1 (95%CI: 2.9-3.3).


CONCLUSIONS
The high risk found in women aged more than 45 years is explained by the increase in the proportion of pregnancies within this age group during the period analyzed. Further studies in perinatal epidemiology that analyze the impact of assisted reproduction techniques in pregnancies in older women are required, as well as a national registry of assisted reproduction techniques.
Luque Fernández
Miguel Angel
MA
Programa de Epidemiología Aplicada de Campo (PEAC), Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain. fmiguelangel@isciii.es
D000328:Adult; D000367:Age Factors; D003627:Data Interpretation, Statistical; D005260:Female; D046689:Fetal Mortality / Q000639:trends*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008423:Maternal Age; D008875:Middle Aged; D016012:Poisson Distribution; D011247:Pregnancy; D015995:Prevalence; D027724:Reproductive Techniques, Assisted; D012307:Risk Factors; D013030:Spain