Pregnancy outcome at extremely advanced maternal age.
OBJECTIVE
The purpose of this study was to evaluate pregnancy outcome in women at extremely advanced maternal age (≥ 45 years).


METHODS
We compared the condition of women aged ≥ 45 years (n = 177) in a 10:1 ratio (20-29, 30-39, and 40-44 years.). Subgroup analysis compared the condition of women aged 45-49 years with those women aged ≥ 50 years.


RESULTS
The rates of gestational diabetes mellitus and hypertensive complications were higher for the study group, compared with the whole group (17.0% vs 5.6% and 19.7% vs 4.5%, respectively; P < .001), as was the rate of preterm delivery at <37 and <34 weeks of gestation (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.2-3.6 and OR, 3.5; 95% CI, 1.4-9.0, respectively). The rates of cesarean delivery (OR, 31.8; 95% CI, 18.0-56.1), placenta previa, postpartum hemorrhage, and adverse neonatal outcome were significantly higher among the study group. The risk for gestational diabetes mellitus, preeclampsia toxemia, preterm delivery, and neonatal intensive care unit admission was increased for women aged ≥ 50 years.


CONCLUSIONS
Pregnancy at extreme advanced maternal age is associated with increased maternal and fetal risk.
Department of Obstetrics and Gynecology, Perinatal Division, Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Yariv
Y
Yogev
Nir
N
Melamed
Ron
R
Bardin
Kinneret
K
Tenenbaum-Gavish
Gadi
G
Ben-Shitrit
Avi
A
Ben-Haroush
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D016001:Confidence Intervals; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005313:Fetal Death; D005316:Fetal Distress / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007557:Israel; D008423:Maternal Age; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D012016:Reference Values; D012189:Retrospective Studies; D055815:Young Adult