title: A significant linear association exists between advanced maternal age and adverse perinatal outcome.
abstract: OBJECTIVE
  The present study was aimed to investigate perinatal outcome of elderly nulliparous patients.
  
  
  METHODS
  A retrospective study was performed comparing pregnancy outcomes of nulliparous patients at three age groups: less than 35 years (reference group), 35-40 years, and above 40 years. The linear-by-linear association test was used to examine linear association between advanced maternal age and adverse pregnancy outcomes. A multiple logistic regression model was used to control for confounders.
  
  
  RESULTS
  Out of 45,033 nulliparous women with singleton gestations, 1,036 were of women over the age of 35, and 188 over 40. A significant linear association was documented between advanced maternal age and adverse outcomes, such as intra uterine growth restriction, low birth weight, congenital malformations, and perinatal mortality. Using a multiple logistic regression model, controlling for gestational age, IUGR and malformations, advanced maternal age was not found to be an independent risk factor for perinatal mortality (adjusted odds ratio = 1.04, 95% confidence interval 0.7-1.4).
  
  
  CONCLUSIONS
  A significant linear association exists between advanced maternal age and adverse maternal and perinatal outcomes. Nevertheless, in our population, advanced maternal age is not an independent risk factor for perinatal mortality.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O. Box 151, Beersheba, Israel.
authors.forename: Shimrit
authors.initials: S
authors.lastname: Salem Yaniv
authors.forename: Amalia
authors.initials: A
authors.lastname: Levy
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.forename: Gershon
authors.initials: G
authors.lastname: Holcberg
authors.forename: Moshe
authors.initials: M
authors.lastname: Mazor
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D008423:Maternal Age; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies