title: Outcomes of multiple gestations with advanced maternal age.
abstract: OBJECTIVE
  To investigate outcomes of twin gestations with advanced maternal age (AMA).
  
  
  METHODS
  Historical cohort of twin gestations cared for by a maternal-fetal medicine faculty practice. Outcomes of patients with AMA (70) and non-AMA (75) were compared. AMA was defined as age > or =35. Analysis including mode of delivery, gestational age at delivery and overall complications was performed. Significance was determined using the chi-square test or the Student's t-test.
  
  
  RESULTS
  The Cesarean rate for AMA was significantly greater compared to non-AMA (80.0% vs. 54.7%; p = 0.001). The main reason for the increased rate was uterine dysfunction. The mean gestational age at delivery for AMA was significantly greater than for non-AMA (36.7 weeks vs. 35.4 weeks; p = 0.02). There were no differences in rates of other adverse outcomes including gestational hypertension, pre-eclampsia, gestational diabetes, suspected fetal growth restriction, preterm birth, low birth weight or low birth weight percentiles. This remained true when we compared the 32 women ages > or =40 years to 118 women ages <40 years.
  
  
  CONCLUSIONS
  Among twin pregnancies, AMA women are not at an increased risk of adverse pregnancy outcomes, aside from an increased rate of cesarean delivery.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York, USA. nfox@mfmnyc.com
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Fox
authors.forename: Andrei
authors.initials: A
authors.lastname: Rebarber
authors.forename: Samantha M
authors.initials: SM
authors.lastname: Dunham
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Saltzman
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D014427:Twins